Efficacy And Safety Of Dilation Through Percutaneous Nephrostomy Approach Combined With Ureteroscopic Approach At An Oblique Supine Lithotomy Position In The Treatment Of Ureteral Stricture

Objective: To study the efficacy and safety of dilation through percutaneous nephrostomy approach combined with ureteroscopic approach at an oblique supine lithotomy position in the treatment of ureteral stricture.Methods: Ten cases of ureteral stricture from April 2015 to April 2018 were retrospectively analyzed,who underwent PNCU dilatation in an oblique supine lithotomy position.Data were retracted from electronic database of Tongji Hospital affiliated Tongji Medical College,Huazhong University of Science and Technology.Patient's general information,medical history,surgical procedure,stricture length and curative effect were analyzed.Results: In this study,10 patients with ureteral stricture,7 females and 3 males,aged(44.73±15.94)years,including 6 cases of upper stricture,4 cases of middle and lower stricture,and the stricture length was 0.92±0.29 cm.Among them,8 patients underwent soft ureteroscope sheath dilation,1 patient underwent balloon dilation,and 1 patient underwent cold incision.All patients successfully underwent PNCU dilatation in an oblique supine lithotomy position,and double equally-sized double J stents were inserted.The operative time was 127.18±33.70 min,no severe bleeding,ureteral perforation or infection occurred after the procedure.All the patients were followed up for 11-47 months after surgery.Double J tubes were successfully removed in eight patients,one patient retained two double J tubes after replacement.One patient underwent robot-assisted pyeloplasty and ureteroplasty 2 years later due to ureteral stricture and hydronephrosis.Conclusion: PNCU dilatation in an oblique supine lithotomy position is safe and effective for various types of ureteral stricture treatment.