Examining the obstructed ureter with intraluminal sonography

Area of Science:

• Urology
• Medical Imaging
• Diagnostic Techniques

Background:

• Ureteral obstruction presents diagnostic challenges.
• Accurate differentiation of ureteral lesions is crucial for effective treatment planning.

Purpose of the Study:

• To evaluate the utility of intraluminal sonography in defining and differentiating ureteral lesions.
• To assess its role in guiding minimally invasive treatment for ureteral obstruction.

Main Methods:

• Intraluminal sonography was employed in 63 patients with suspected ureteral stricture.
• A diagnostic algorithm included retrograde contrast imaging, ureteroscopy, and intraluminal sonography.
• Specific sonographic criteria were developed to classify stricture types and identify complicating factors.

Main Results:

• Sonography differentiated various ureteral stricture types, including wall fibrosis (36%), edema (19%), retroperitoneal fibrosis (10%), and scarring (12%).
• It identified complicating factors like foreign bodies, stone fragments, submucosal tumors, endometriosis, and urinomas.
• Ultrasound guidance facilitated safe endoscopic treatment, avoiding adjacent vasculature.

Conclusions:

• Intraluminal sonography is valuable for diagnosing ureteral obstruction of unclear etiology.
• It aids in selecting patients for minimally invasive therapies and safely directing these treatments.
• This technique improves the management of complex ureteral lesions.