[Endotomy in treating strictures of the upper urinary tract]

The analysis of outcomes of 102 operations of transurethral and percutaneous endotomy in 100 patients is provided. Primary strictures of the upper urinary tract (UUT) were detected in 26 cases. Postoperative strictures existed up to 3 months in 19 cases, 3 to 12 months in 21 cases and at least 12 months in 36 cases. The causes of the strictures lie in previous surgical interventions on the UUT. Of the 102 endoscopic operations, 49 ones were conducted via percutaneous approach, nephrostomic fistula was used in 11 cases. In 42 endotomies the approach to UUT strictures was transurethral, a "cold knife" was applied in 78 operations, electric current in 24 cases. Follow-up for 12 months to 9 years documented good and satisfactory results in 90 (90%) patients. Open operative intervention was necessary for elimination of the intraoperative complication in 1 case, of the postoperative one also in 1 case. The remaining endotomy complications were treated conservatively. Reoperations due to endotomy failure were made in 8 cases of 10. Endotomy of UUT strictures is indicated in primary and early postoperative strictures 0-1 cm in size located at any site of normally developed UUT accessible for rigid endoscopic instruments from percutaneous or transurethral approaches.