Mr. J, 31 years old, male came in urology OPD with left loin pain radiated to left inguinal area. Patient had history of Tonsillectomy 2012, HTN.

O/E: Left lower abdomen was tender, Ext. gent. Normal, DRE-normal.

Urine RME & Sr. Creatinine were normal,

X-ray LS - Degenerative change of dorsal spine,

USG of KUB – Left sided hydronephrosis,

CT KUB with extra contrast- Left sided hydronephrosis due to stricture left lower ureter.

On 26.11.18 Cystoscopy B/L RGP + Left Lower ureteric dilatation + D-J stenting done under spinal anesthesia,

The balloon catheter was placed through narrow ureter along the guide wire, and the balloon was pressurized to 25 atm & Dilated, expansion for 10 min,dilatation performed distally & proximally of stricture part,  then D-J stent well kept.

After 2.5 months Left D-J stent was removed under local anesthesia.

Till now patient has no complain

 

Ureteric Stricture – can block or narrow the ureter & making it difficult to pass urine from the kidney to bladder.

 

Ureteric stricture can lead to urinary dilatation, water accumulation, and renal colic in the upper segment of the stenosis. If treat not in time, it will affect renal function and even causes irreversible kidney failure. In recent years, with the development of endoscopic techniques, it provides a cost-effective and less invasive treatment for the treatment of ureteral stricture and has achieved satisfactory results.

Therefore, more and more urologists choose to treat ureteral stricture under endoscopy. The techniques of urinary endoscopic treatment of ureteric stricture include ureteric balloon dilatation, ureteral holmium laser incision, and ureteral stent implantation. Among them, the ureteric balloon dilatation technique is characterized by the use of a balloon to uniformly force the ureteral wall, tearing the narrow scar tissue, expanding the inner diameter of the ureter, re-canalizing the urinary tract, and alleviating hydronephrosis. It have been reported with less complications and simple procedure.

Approach Considerations

No accepted medical treatment of ureteric strictures currently exists. Surgical procedures used in these patients include the following:

• Balloon dilation
• Endo-ureterotomy
• Placement of metal ureteral stents
• Open surgery