Benign ureteric strictures--management by percutaneous interventional uro-radiological techniques

Nineteen patients with benign ureteric strictures were treated by an antegrade approach. Following percutaneous nephrostomy, the strictures were dilated by either tapered dilating catheters or angiographic balloon catheters and temporarily stented using internal double J ureteral stents. The strictures were most commonly caused by calculous disease, post-radical hysterectomy and inflammatory disease, including tuberculosis and candidiasis. The majority (73%) were situated in the distal third of the ureter. Short strictures less than 3 cm in length were present in eight patients (36%) while in ten patients the age of the stricture was less than three months. In two patients, the strictures were too severe and could not be crossed by guidewires and those patients required reimplantation of the ureter. In 16 patients, the strictures were successfully dilated. Follow-up period ranged from five months to twenty-six months (mean 13 months). There were no complications directly related to dilatation. The aetiology and age of an ureteric stricture are the most important factors in predicting the success of ureteric dilatation. This review demonstrates that early treatment of strictures by percutaneous techniques, even those that may be devascularised by the underlying disease process, should usually be successful.