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Endoscopic management of ureteral strictures.

PURPOSE: We investigated and defined the role of endourological methods in the treatment of patients with ureteral stricture.

MATERIALS AND METHODS: A literature search was performed of the MEDLINE data base from 1978 through August 1996 concerning endoscopic treatment of patients with ureteral strictures. Additional articles from before 1978 were also selectively included.

RESULTS: Many endourological methods are available to treat patients with ureteral strictures. Ureteral dilation via an antegrade or retrograde approach may be accomplished in most cases with varying rates of success depending on stricture etiology, location and length. Endoscopic ureterotomy may also lead to long-term patency in select cases and appears to be superior to dilation alone in patients with anastomotic ureteral strictures. However, no randomized studies comparing endourological methods in the treatment of ureteral stricture disease were found.

CONCLUSIONS: Significant advances in technique and technology have led to an improved ability to treat ureteral strictures without the need for open surgery in many patients.

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