eMedicine Specialties > Urology > Strictures

Ureteral Stricture: Multimedia

Author: Benjamin N Breyer, MD, Clinical Instructor, Department of Urology, University of California - San Francisco
Coauthor(s): Christopher J Kane, MD, FACS, Professor of Surgery, Chief of Urology, University of California San Diego
Contributor Information and Disclosures

Updated: Aug 17, 2009

Multimedia

Ureteral stricture. Intravenous pyelogram (IVP) i...
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Media file 1: Ureteral stricture. Intravenous pyelogram (IVP) in a woman 4 weeks after a total abdominal hysterectomy for endometriosis. A ureteral injury was identified intraoperatively and repaired by the gynecologist. The IVP image reveals a high-grade right distal ureteral stricture.
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Ureteral stricture. Intravenous pyelogram (IVP) i...

Ureteral stricture. Intravenous pyelogram (IVP) in a woman 4 weeks after a total abdominal hysterectomy for endometriosis. A ureteral injury was identified intraoperatively and repaired by the gynecologist. The IVP image reveals a high-grade right distal ureteral stricture.

Ureteral stricture. The same patient as in Image ...
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Media file 2: Ureteral stricture. The same patient as in Image 1, after a combined antegrade and retrograde endoureterotomy of the completely obliterated stricture with holmium:YAG laser, subsequent dilation to 15F with a ureteral dilating balloon, and stenting with a double-J ureteral stent. The image is an antegrade nephrostogram prior to removal of the nephrostomy tube. The patient is asymptomatic and stent-free without obstruction 3 months after the procedure.
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Ureteral stricture. The same patient as in Image ...

Ureteral stricture. The same patient as in Image 1, after a combined antegrade and retrograde endoureterotomy of the completely obliterated stricture with holmium:YAG laser, subsequent dilation to 15F with a ureteral dilating balloon, and stenting with a double-J ureteral stent. The image is an antegrade nephrostogram prior to removal of the nephrostomy tube. The patient is asymptomatic and stent-free without obstruction 3 months after the procedure.

Ureteral stricture. This right retrograde pyelogr...
(Enlarge Image)
Media file 3: Ureteral stricture. This right retrograde pyelogram reveals a tight right midureteral stricture in a man 3 years after an aortobifemoral bypass for obstructive peripheral vascular disease. The man presented with azotemia and bilateral hydroureteronephrosis to the mid ureters. Bilateral stents were placed, and subsequent bilateral ureterolysis with omental wrapping was performed. Both ureters were encased in a dense inflammatory process anterior to the vascular graft.
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Ureteral stricture. This right retrograde pyelogr...

Ureteral stricture. This right retrograde pyelogram reveals a tight right midureteral stricture in a man 3 years after an aortobifemoral bypass for obstructive peripheral vascular disease. The man presented with azotemia and bilateral hydroureteronephrosis to the mid ureters. Bilateral stents were placed, and subsequent bilateral ureterolysis with omental wrapping was performed. Both ureters were encased in a dense inflammatory process anterior to the vascular graft.

More on Ureteral Stricture

Overview: Ureteral Stricture
Workup: Ureteral Stricture
Treatment: Ureteral Stricture
Follow-up: Ureteral Stricture
Multimedia: Ureteral Stricture
References
Further Reading
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References

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  2. Vakili B, Chesson RR, Kyle BL, Shobeiri SA, Echols KT, Gist R, et al. The incidence of urinary tract injury during hysterectomy: a prospective analysis based on universal cystoscopy. Am J Obstet Gynecol. May 2005;192(5):1599-604. [Medline].

  3. Wolf JS Jr, Elashry OM, Clayman RV. Long-term results of endoureterotomy for benign ureteral and ureteroenteric strictures. J Urol. Sep 1997;158(3 Pt 1):759-64. [Medline].

  4. Karod JW, Danella J, Mowad JJ. Routine radiologic surveillance for obstruction is not required in asymptomatic patients after ureteroscopy. J Endourol. Jul-Aug 1999;13(6):433-6. [Medline].

  5. Chung SY, Stein RJ, Landsittel D, Davies BJ, Cuellar DC, Hrebinko RL, et al. 15-year experience with the management of extrinsic ureteral obstruction with indwelling ureteral stents. J Urol. Aug 2004;172(2):592-5. [Medline].

  6. Grasso M, Li S, Liu JB, Beaghler M, Newman R, Bagley DH. Examining the obstructed ureter with intraluminal sonography. J Urol. Oct 1999;162(4):1286-90. [Medline].

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  11. Liatsikos EN, Kagadis GC, Karnabatidis D, Katsanos K, Papathanassiou Z, Constantinides C, et al. Application of self-expandable metal stents for ureteroileal anastomotic strictures: long-term results. J Urol. Jul 2007;178(1):169-73. [Medline].

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  15. Nezhat CH, Nezhat F, Seidman D, Nezhat C. Laparoscopic ureteroureterostomy: a prospective follow-up of 9 patients. Prim Care Update Ob Gyns. Jul 1 1998;5(4):200. [Medline].

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  24. Harmon WJ, Sershon PD, Blute ML, Patterson DE, Segura JW. Ureteroscopy: current practice and long-term complications. J Urol. Jan 1997;157(1):28-32. [Medline].

  25. HSU TMS, Streem SB, Nakada SY. Management of upper urinary tract obstruction. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, eds. Campbell-Walsh Urology. Vol 2. 9th ed. Philadelphia, Pa: WB Saunders; 2007:1227-73.

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  27. Meng MV, Freise CE, Stoller ML. Expanded experience with laparoscopic nephrectomy and autotransplantation for severe ureteral injury. J Urol. Apr 2003;169(4):1363-7. [Medline].

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  30. Weinberg JJ, Ansong K, Smith AD. Complications of ureteroscopy in relation to experience: report of survey and author experience. J Urol. Mar 1987;137(3):384-5. [Medline].

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Keywords

ureteral stricture, ureteral obstruction, hydronephrosis, ureteral scar, ureteropelvic junction obstruction, UPJ obstruction, urethral narrowing, narrow urethra, congenital obstructing megaureter, ureteroscopy, laparoscopic injury, gynecologic injury, urologic injury, vascular injury, genitourinary trauma, gynecologic trauma, urologic trauma, radiation therapy, radiotherapy, urinary diversion, renal transplant, kidney transplant, ureteral ischemia, ureteral fibrosis, benign intrinsic stricture, benign intrinsic ureteral stricture, malignant ureteral stricture, retroperitoneal fibrosis, iatrogenic ureteral stricture, stricture disease

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Contributor Information and Disclosures

Author

Benjamin N Breyer, MD, Clinical Instructor, Department of Urology, University of California - San Francisco
Benjamin N Breyer, MD is a member of the following medical societies: American College of Surgeons and American Urological Association
Disclosure: Nothing to disclose.

Coauthor(s)

Christopher J Kane, MD, FACS, Professor of Surgery, Chief of Urology, University of California San Diego
Christopher J Kane, MD, FACS is a member of the following medical societies: American College of Surgeons and American Urological Association
Disclosure: Nothing to disclose.

Medical Editor

Daniel B Rukstalis, MD, Director of Urological Services, Geisinger Medical Center, Geisinger Medical Group
Daniel B Rukstalis, MD is a member of the following medical societies: American Association for the Advancement of Science and American Urological Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

CME Editor

J Stuart Wolf Jr, MD, FACS, David A Bloom Professor of Urology, Director of Division of Minimally Invasive Urology, Department of Urology, University of Michigan
J Stuart Wolf Jr, MD, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Catholic Medical Association, Endourological Society, Society for Urology and Engineering, Society of Laparoendoscopic Surgeons, Society of University Urologists, and Society of Urologic Oncology
Disclosure: Terumo Corporation Consulting fee Consulting; Omeros Corporation Consulting fee Consulting

Chief Editor

Bradley Fields Schwartz, DO, FACS, Professor of Urology, Director, Center for Laparoscopy and Endourology, Department of Surgery, Southern Illinois University School of Medicine
Bradley Fields Schwartz, DO, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Association of Military Osteopathic Physicians and Surgeons, Endourological Society, Society of Laparoendoscopic Surgeons, and Society of University Urologists
Disclosure: Nothing to disclose.

 
 
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