Ureteric stricture formation following ureteric instrumentation in patients with a nephrostomy drain in place

To determine what effect the presence of a nephrostomy, left on free drainage, might have on the rate of occurrence of ureteric strictures after ureteric instrumentation.

Eighteen patients were identified in this unit who had had ureteric instrumentation while a nephrostomy was in place.

Eight of 11 patients in whom the nephrostomy was left open developed ureteric strictures. None of seven patients in whom the lumen was maintained by stenting and/or clamping of the nephrostomy developed strictures. The strictures needed dilatation and stenting in seven patients and the ureter had to be reimplanted in the other.

In patients in whom a nephrostomy is in place, the opening should be occluded after ureteric instrumentation or a stent should be inserted if it is to be left on free drainage.