| Objective:The hydronephrosis caused by ureteral strictures was treated by open surgical repair。Nowadays, the endourological procedures including endoureterotomy and ureteral balloon dilatation have been proved effective. Minimally invasive approaches are often the initial option of treating ureteral strictures because of their reduced complication, reduced operative time, shorter length of stay with an open reconstruction. The objective of this study is to evaluate the efficacy of treatment of ureteral strictures by balloon dilatation in a retrograde fashion.Methods:Between June 2013 and September 2014,42 patients were treated by balloon dilatation or open surgery. Pain (22 patients), recurrent urinary tract infection (9 patients) and only ultrasonography abnormal (13 patients) were showed in the patients. Intraudio videoenous urography, retrograde urography, routine urine test, CT, emission computed tomography (ECT) were done to clear the location and length of the ureteral strictures. All the strictures were benign and not compressed by the outer tissue of ureters. All the patients were divided into 2 groups by operation method. In group 1,22 patients (10men and 12women) were treated by balloon dilatation. The mean age was 42 years (range,23-65years). The mean body weight was 60.6kg (range, 41-75kg). The mean length of strictures was 1.16cm (range,0.5-2.0cm).77.3%(17/22) of the strictures were located in the distal ureter,3 in the middle and 2 in the proximal. In group 2,20 patients (10men and 10women) were treated by open surgery. The mean age was 34 years (range,16-67years). The mean body weight was 59.7kg (range, 46-89kg). The mean length of strictures was 1.30cm (range,0.5-2.0cm).70%(14/20) of the strictures were located in the distal ureter and 6 in the proximal.Results:All the 42 patients experienced successful operation after general anesthesia and there was no complication occurred during the operation. All the strictures were proved benign after the procedure. The procedural time in groupl was 42.3±16.2 minutes and 112.25±32.6 minutes in group 2. The estimated blood loss were 10.0±4.1ml and 120.0±21.9ml, respectively. And no patients needing blood transfusion. There were significant differences between the two groups in comparing those parameters above (P＜0.05). Only 1 patient was found bleeding after operation and treated by drainage. Ureteral stents were placed in all the patients after operation for 3-6 months according to the condition of the patients. The patients in group 1 were followed up for 6.0±2.5 months and 7.1±2.4 months in group 2 and there were no significant differences between the two groups (P=0.172). The patients in group 1 gained a satisfactory recovery after a hospital stay of 2.6±0.6 days and 8.5±1.1 in group 2. There were significant differences between the two groups (P=0.001). The effective rate of group 1 was 81.8%(18/22) according to the clinical manifestation after Ureteral stents were removed and 85%(17/20) in group 2. There were no significant differences between the two groups in effective rate (P=0.782).Conclusion:Balloon dilatation in a retrograde fashion is effective in treating benign ureteral strictures whose length are less than 2cm. It has less complication, less operative time and shorter length of stay compared to open surgery. |
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