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Evaluating bilharzial ureteropathy for surgery

I Husain, I H Al Ali, A S Kinare

    British Journal of Urology
    |December 1, 1980
    PubMed
    Summary
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    This study defines four patterns of ureteropathy caused by bilharzia in 115 ureters. Different types require distinct management strategies, from observation to surgical intervention, aiding in patient evaluation and follow-up.

    Area of Science:

    • Urology
    • Parasitology
    • Medical Imaging

    Background:

    • Chronic bilharziasis (schistosomiasis) can lead to significant ureteral pathology.
    • Understanding ureteral changes is crucial for effective patient management.

    Purpose of the Study:

    • To classify and describe patterns of ureteropathy in chronic bilharziasis.
    • To guide diagnostic and therapeutic strategies based on ureteral changes.

    Main Methods:

    • Analysis of 115 ureters with chronic bilharzial changes.
    • Classification into four distinct patterns (A, B, C, D).
    • Inclusion of fluoroscopy for evaluating Type C ureteropathy.

    Main Results:

    • Type A: Benign, distal fusiform dilatation, no surgery needed.

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  • Type B: Distal stricture, good surgical outcomes with resection and reimplantation.
  • Type C: Extensive changes without stricture, requires fluoroscopy; severe cases need ileal segment.
  • Type D: Fixed upper ureteric tortuosity, successful conservative surgery.

    • Conclusions:

    • A four-type classification system for bilharzial ureteropathy is effective.
    • Staging ureteropathy aids in evaluation and follow-up.
    • Tailored management based on ureteral pattern improves outcomes.