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Ureteric Stricture Disease
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===== Options (2): ===== # '''<span style="color:#ff0000">Balloon dilation</span>''' # '''<span style="color:#ff0000">Endoureterotomy</span>''' ====== Balloon dilation ====== *Efficacy **Success rates range from 50-76%, long-term outcomes are unfavorable **'''Best results obtained in patients with iatrogenic, non-anastomotic strictures such as those secondary to ureteroscopic instrumentation'''. In that setting, a success rate of 85% was achieved compared with a rate of 50% for anastomotic strictures *Technique **After 10 minutes of tamponade, the balloon is deflated and withdrawn. **An internal stent is passed over a guidewire still in place, which is left indwelling for 2-4 weeks. *'''Post-operative follow-up''' **'''Diuretic renography''' is usually performed β1 month after stent extraction and at 6- to 12-month intervals thereafter ====== Endoureterotomy ====== *'''<span style="color:#ff0000">Technique</span>''' **'''<span style="color:#ff0000">Incision</span>''' ***'''<span style="color:#ff0000">Position is chosen as a function of the level of the ureter involved. In general</span>''' ****'''Lower ureteral strictures are incised in an anteromedial direction to stay away from the iliac vessels''' ****'''Upper ureteral strictures are incised laterally or posterolaterally''' ***Can be performed using a cold knife, a cutting electrode, or a holmium laser
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