Treatment of benign ureteral stenosis: retrospective analysis of 90 cases in single-center

doi:10.3877/cma.j.issn.1674-3253.2021.04.010

Abstract

Abstract:

Objective

To retrospectively analyze the etiology and treatment effects of ureteral stenosis.

Methods

The clinical data of patients with benign ureteral strictures admitted to Beijing Tsinghua Changgung Hospital from December 2014 to February 2018. Patients were divided into 3 groups according to the length of stenotic lesions (unit: centimeter): group A (χ≤1), group B (1<χ≤2) and group C (χ>2). All patients underwent endoscopic surgery or open/laparoscopic resection of stenosis site and re-anastomosis and other urinary tract reconstruction operations.

Results

There were 117 sides of stenosis treated. The methods were endoscopy and open/laparoscopic ureteroplasty. The effective rate of endoscopic treatment was 45.3% and 80.6% for open/laparoscopic ureteroplasty. The effective rate of open/laparoscopic surgery is higher than that of the endoscopic treatment (P=0.01). The effective rate in group A, B and C was 51.3%,44.1% and 63.3% respectively and there was no significant difference among them (P=0.43).

Conclusions

Open/laparoscopic ureteroplasty is more effective than endoscopic treatment of benign ureteral stenosis. For some proper cases of ureteral stricture, endoscopic surgery can be the first choice of treatment. Even if the endoscopic surgery fails, open/laparoscopic ureteroplasty can still be performed in the second stage, and the treatment effect is satisfactory.

Key words: Ureteral stenosis, Balloon dilatation, Laparoscopy, Endoscopy

Song Chen, Yuzhe Tang, Meng Fu, Boxing Su, Yubao Liu, Bo Xiao, Weiguo Hu, Jianxing Li. Treatment of benign ureteral stenosis: retrospective analysis of 90 cases in single-center[J]. Chinese Journal of Endourology(Electronic Edition), 2021, 15(04): 313-316.

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References 20

[1]	Tran H, Arsovska O, Paterson RF, et al. Evaluationofrisk factors and treatment options in patients with ureteral stricture disease at a single institution[J]. Can Urol Assoc J, 2015, 9(11-12): E921-E924.
[2]	刘刚勇，孙毅海. 良性输尿管狭窄的临床研究及腔内治疗进展[J].微创医学, 2018, 13(4): 485-487.
[3]	Reus C, Brehmer M. Minimally invasive management of ureteral strictures: a 5-year retrospective study[J].World J Urol, 2019, 37(8): 1733-1738.
[4]	Lu C, Zhang W, Peng Y, et al. Endoscopic balloon dilatation in the treatment of benign ureteral strictures: a meta-analysis and systematic review[J]. J Endourol, 2019, 33(4): 255-262.
[5]	惠强，秦荣良，高学林, 等. 球囊扩张术治疗继发性输尿管狭窄疗效分析[J]. 现代泌尿外科杂志, 2020, 25(3): 225-229.
[6]	Srougi V, Padovani GP, Marchini GS, et al. Outcomes of surgical treatment of ureteral strictures after laser ureterolithotripsy for impacted stones[J]. Can J Urol, 2015, 22(6): 8079-8084.
[7]	Gnessin E, Yossepowitch O, Holland R, et al. Holmium laser endoureterotomy for benign ureteral stricture: a single center experience[J]. Urol, 2009, 182(6): 2775-2779.
[8]	Lin CM, Tsai TH, Lin TC, et al. Holmium: yttrium-aluminum-garnet laser endoureterotomy for benign ureteral strictures: a single-centre experience[J]. Acta Chir Belg, 2009, 109(6): 746-750.
[9]	李柳林，孔垂则，刘贤奎, 等. 输尿管镜下逆行球囊扩张术治疗良性输尿管狭窄的临床研究[J/CD]. 中华腔镜泌尿外科杂志(电子版), 2019, 13(2): 85-90.
[10]	徐金戈，张俊文，李俊谕. 单纯球囊扩张联合输尿管镜钬激光内切开治疗输尿管狭窄的疗效观察[J]. 临床医学, 2020, 40(5): 77-79.
[11]	蔡忠林，李文娟，周川, 等. 单纯球囊扩张与联合内切开治疗嵌顿性结石术后输尿管狭窄的疗效比较[J/CD]. 中华腔镜泌尿外科杂志(电子版), 2017, 11(6): 372-375.
[12]	HanPK, Rohan M, Mohd Adam B. The short-termoutcome of laser endoureterotomy for ureteric stricture[J]. Med J Malaysia, 2013, 68(3): 222-226.
[13]	Gdor Y, Gabr AH, Faerber GJ, et al. Success of laser endoureterotomy of ureteral strictures associated with ureteral stones is related to stone impaction[J]. J Endourol, 2008, 22(11): 2507-2511.
[14]	Ibrahim HM, Mohyelden K, Abdel-Bary A, et al. Single versus double ureteral stent placement after laser endoureterotomy for the management of benign ureteral strictures: a randomized clinical trial[J]. J Endourol, 2015, 29(10): 1204-1209.
[15]	Xu N, Chen SH, Xue XY, et al. Comparison of retrograde balloon dilatation and laparoscopic pyeloplasty for treatment of ureteropelvic junction obstruction: results of a 2-year follow-up[J]. PLoS One, 2016, 11(3): e0152463.
[16]	袁彪，蒋宏毅. 输尿管镜下球囊扩张术与腹腔镜下输尿管成形术治疗良性输尿管狭窄的疗效比较[J]. 中华实用诊断与治疗杂志. 2020, 34(9): 947-950.
[17]	刘任平，许婷，俆苓傈. 三种不同术式治疗输尿管狭窄的疗效及安全性分析[J]. 微创泌尿外科杂志, 2019, 8(2): 88-92.
[18]	姜言梦，张能，陈书练, 等. 输尿管狭窄腔内治疗进展[J]. 齐齐哈尔医学院学报. 2019, 40(24): 3120-3122.
[19]	Zhang S, Zhang Q, Ji C, et al. Improved split renal function after percutaneous nephrostomy in young adults with severe hydronephrosis due to ureteropelvic junction obstruction[J]. J Urol, 2015, 193(1): 191-195.
[20]	Nayyar R, Yadav S, Singh P, et al. Outcomes of pyeloplasty in very poorly functioning kidneys: examining the myths[J]. Urology, 2016, 92:132-135.

病因		例数	百分率(%)
肾盂输尿管连接部梗阻		26	28.9
	未治疗	7
	肾盂输尿管成形术后失败	19
结石相关性		53	58.9
医源（非结石）性狭窄		7	7.8
	输尿管膀胱再植术后	2
	输尿管吻合术后	1
	经尿道电切损伤输尿管口	1
	结肠术后	1
	剖宫产术后	1
	子宫切除术后	1
原发性输尿管狭窄		2	2.2
输尿管外伤		1
子宫内膜异位症		1

病因		例数	百分率(%)
肾盂输尿管连接部梗阻		26	28.9
	未治疗	7
	肾盂输尿管成形术后失败	19
结石相关性		53	58.9
医源（非结石）性狭窄		7	7.8
	输尿管膀胱再植术后	2
	输尿管吻合术后	1
	经尿道电切损伤输尿管口	1
	结肠术后	1
	剖宫产术后	1
	子宫切除术后	1
原发性输尿管狭窄		2	2.2
输尿管外伤		1
子宫内膜异位症		1

狭窄情况		段数	百分率
部位
	肾盂输尿管连接部	53	45.3%
	上段	32	27.4%
	中段	13	11.1%
	下段	19	16.2%
长度（cm）
	χ≤1	48	41.0%
	1<χ≤2	50	42.7%
	χ>2	19	16.2%

狭窄情况		段数	百分率
部位
	肾盂输尿管连接部	53	45.3%
	上段	32	27.4%
	中段	13	11.1%
	下段	19	16.2%
长度（cm）
	χ≤1	48	41.0%
	1<χ≤2	50	42.7%
	χ>2	19	16.2%

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