Post ureteroscopic stone surgery ureteral strictures management: a retrospective study

Area of Science:

• Urology
• Surgical Outcomes
• Endourology

Background:

• Ureteral strictures are a complication following ureteroscopic lithotripsy.
• Management strategies vary, impacting patient outcomes.

Purpose of the Study:

• To evaluate and compare the effectiveness of different management strategies for ureteral strictures after ureteroscopic lithotripsy.
• To identify factors influencing treatment success.

Main Methods:

• Retrospective analysis of 95 patients with ureteral strictures post-ureteroscopic lithotripsy (2013-2018).
• Comparison of endourological treatment (n=53) versus reconstructive surgery (n=34).
• Therapeutic success defined by symptom absence and radiologic relief of obstruction.

Main Results:

• Reconstruction achieved a significantly higher success rate (97.3%) than endourological procedures (60.9%) (p < 0.001).
• Endourological procedures showed acceptable success for strictures < 1 cm (74.4%) and mild-to-moderate hydronephrosis (68.8%).
• Multivariate analysis confirmed reconstruction as a predictor of successful outcome (HR 0.052, p=0.004).

Conclusions:

• Reconstructive surgery demonstrates superior surgical outcomes for ureteral strictures compared to endourological interventions.
• Endourological procedures are a viable option for select patients with shorter strictures and minimal hydronephrosis.
• The majority of ureteral stricture recurrences are observed within the first year post-treatment.