Intraureteral metallic self-expanding endoprosthesis (Wallstent) in the treatment of difficult ureteral strictures.
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.
Reinberg
Y
Y
Department of Urology, University of Minnesota, Minneapolis.
Ferral
H
H
Gonzalez
R
R
Manivel
J C
JC
Hulbert
J
J
Maynar
M
M
Pulido-Duque
J M
JM
Hunter
D
D
Castaneda-Zuniga
W R
WR
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*