title: Intraureteral metallic self-expanding endoprosthesis (Wallstent) in the treatment of difficult ureteral strictures.
abstract: Intractable and recurrent ureteral stricture presents a continuous challenge to the urologist. We report on 5 patients with severe ureteral stricture who were successfully treated with self-expanding metallic stents. Ureteral stricture occurred at ureteroileal anastomotic sites after neoplasm resection in 2 cases, multiple upper ureteral strictures were related to multiple surgical procedures for correction of bladder exstrophy in 1 and a ureteral kink developed in 1. Treatment with transluminal balloon dilation provided poor results but self-expanding metallic stents were used successfully with no major complications. In the last patient the stent and the overlying ureter were removed due to recurrent reflux; the gross and histological ureteral changes are discussed in detail. The technical approach is described, alternative therapeutic options are considered and pertinent literature is reviewed.
authors.affiliation: Department of Urology, University of Minnesota, Minneapolis.
authors.forename: Y
authors.initials: Y
authors.lastname: Reinberg
authors.forename: H
authors.initials: H
authors.lastname: Ferral
authors.forename: R
authors.initials: R
authors.lastname: Gonzalez
authors.forename: J C
authors.initials: JC
authors.lastname: Manivel
authors.forename: J
authors.initials: J
authors.lastname: Hulbert
authors.forename: M
authors.initials: M
authors.lastname: Maynar
authors.forename: J M
authors.initials: JM
authors.lastname: Pulido-Duque
authors.forename: D
authors.initials: D
authors.lastname: Hunter
authors.forename: W R
authors.initials: WR
authors.lastname: Castaneda-Zuniga
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002408:Catheters, Indwelling; D002675:Child, Preschool; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D011859:Radiography; D015607:Stents; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging / Q000628:therapy*