尿管狭窄に対するEndourological Management

Abstract

Endourological management was employed in five cases with ureteral strictures. The cause of stricture included ureteroileal anastomoses in two cases, open pyeloplasty in one, radical hysterectomy in one and retroperitoneal fibrosis in one. In four cases, strictures were dilated using a balloon dilation catheter (diameter 4 to 8 mm), followed by placement of ureteral stent (6 to 8.3 Fr), for from 8 days to 43 days. In one case, graduated flexible dilator was passed until a 10 Fr opening was obtained. A 6 Fr ureteral stent was placed for 42 days. Of the 5 strictures 3 were dilated successfully as judged by excretory urogram. Followup ranged from 7 months to 19 months. Unsuccessful dilation occurred in 2 cases. In one case, subsequent exploratory operation revealed retroperitoneal fibrosis. In another case, subsequent CT scan disclosed the metastasis of rectal cancer obstructing the site of ureteroileal anastomosis. Endourological procedure is valuable in the treatment of benign post-operative ureteral stricture.