Outcomes and management of de novo ureteral strictures following ureteroscopy: A retrospective observational study

Ureteral strictures are a recognised late complication post ureteroscopy (URS). Most research on the pathology focuses on mechanisms of injury and preventative strategies. There is limited data describing follow up patterns and treatment outcomes. The aim was to evaluate the subsequent management and outcomes of de novo ureteral strictures post URS.

Retrospective review was conducted of patients diagnosed with a de novo ureteral stricture post URS at a tertiary centre between 2014 and 2024. Eligible cases were identified by manual review of ICD-coded records (N13.0-N13.5), yielding 40 patients for analysis. Baseline and procedural data were summarised descriptively, and group comparisons were performed using the Mann-Whitney U and Fisher's exact tests.

Among 40 patients (median age 69 years), most strictures were detected symptomatically (67.5%) and were located proximally or distally (each 43%). Median time to diagnosis was 3.8 months, and median follow-up was 4.3 years. Overall, 45% achieved successful resolution after a median of two procedures, while 15% underwent nephrectomy. Higher age-adjusted Charlson Comorbidity Index scores and older age were significantly associated with poorer outcomes, although interpretation is limited by the sample size. Stricture length and a history of stone impaction showed no significant associations.

In this cohort, fewer than half of patients with de novo ureteral strictures following URS achieved lasting resolution despite multiple interventions. These findings highlight the potential clinical burden of this complication and support the importance of preventive strategies, timely detection and structured follow-up, while underscoring the need for further studies to better define long-term outcomes.