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Sugino T, Taguchi K, Hamamoto S, et al. Risk Factors for Failure of Endoscopic Management of Stone-related Ureteral Strictures. Urol J. 2021;6697doi: 10.22037/uj.v18i.6697.
Sugino, T., Taguchi, K., Hamamoto, S., Okada, T., Isogai, M., Tanaka, Y., Unno, R., Fujii, Y., Hamakawa, T., Ando, R., Okada, A., & Yasui, T. (2021). Risk Factors for Failure of Endoscopic Management of Stone-related Ureteral Strictures. Urology journal, 6697. https://doi.org/10.22037/uj.v18i.6697
Sugino, Teruaki, et al. "Risk Factors for Failure of Endoscopic Management of Stone-related Ureteral Strictures." Urology journal vol. (2021): 6697. doi: https://doi.org/10.22037/uj.v18i.6697
Sugino T, Taguchi K, Hamamoto S, Okada T, Isogai M, Tanaka Y, Unno R, Fujii Y, Hamakawa T, Ando R, Okada A, Yasui T. Risk Factors for Failure of Endoscopic Management of Stone-related Ureteral Strictures. Urol J. 2021 Aug 25;6697. doi: 10.22037/uj.v18i.6697. Epub 2021 Aug 25. PMID: 34431077.
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Urol J. 2021 Aug 25;6697. doi: 10.22037/uj.v18i.6697. Epub 2021 Aug 25.

Risk Factors for Failure of Endoscopic Management of Stone-related Ureteral Strictures.

Urology journal

Teruaki Sugino, Kazumi Taguchi, Shuzo Hamamoto, Tomoki Okada, Masahiko Isogai, Yutaro Tanaka, Rei Unno, Yasuhiro Fujii, Takashi Hamakawa, Ryosuke Ando, Atsushi Okada, Takahiro Yasui

Affiliations

  1. Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan. [email protected].
  2. Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan. [email protected].
  3. Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan. [email protected].
  4. Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan. [email protected].
  5. Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan. [email protected].
  6. Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan. [email protected].
  7. Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan. [email protected].
  8. Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan. [email protected].
  9. Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan. [email protected].
  10. Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan. [email protected].
  11. Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan. [email protected].
  12. Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya, Japan. [email protected].

PMID: 34431077 DOI: 10.22037/uj.v18i.6697

Abstract

PURPOSE: To investigate factors determining the outcomes of endoscopic management for stone-related ureteral stricture.

MATERIALS AND METHODS: Data of patients who underwent endoscopic surgery for ureteral stricture due to stones from January 2016 to April 2020 were retrospectively analyzed. We compared cases successfully treated with endoscopic surgery with cases that resulted in failure. We focused on factors associated with treatment success, including cause and length of stricture, methods of stricture treatment, surgical time, and duration of hydronephrosis before the treatment. Treatment success was defined as improvement in hydronephrosis status.

RESULTS: Nineteen patients were treated for stone-related ureteral stricture. Hydronephrosis was successfully improved in 12 patients (63.2%). Seven patients with failed endoscopic management had ureteroscopic lithotripsy-related stricture, whereas 3/12 (25.0%) patients with ureteroscopic lithotripsy-related stricture and 7/12 (58.3%) patients with impacted stone-related stricture were successfully treated by endoscopic management (P = .004). The prevalence of stricture length > 15 mm was significantly higher in the patients with failed management than in the patients with successful management (71.4 vs 16.6%, P = .046). Intraoperative endoscopic observation demonstrated that the mucosa of the ureteroscopic lithotripsy-related stricture had ischemic appearance with relatively long stricture length (P = 0.13) compared to the impacted stone-related stricture. No association was observed between treatment outcome and method of endoscopic management, including laser incision, balloon dilation, or both.

CONCLUSION: Ureteroscopic lithotripsy as a cause and stricture length > 15 mm could affect the success rate of endoscopic management of ureteral stricture. In such cases, reconstructive management should probably be considered in the early stages.

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