| Objective: Ureteral stricture is a rare disease in the urinary system,but it is extremely difficult to treat once it happened.If it fails to be treated in time,it can cause hydronephrosis in the affected side.In severe cases,it may lead to renal insufficiency and renal failure.In recent years,with the development of urologic laparoscopic surgery,iatrogenic ureteral stricture caused by laparoscopic surgery is increasing,which should be highly valued by urologists,but at the same time the development of laparoscopic surgery provides a new treatment for ureteral stricture.Transurethral ureteroscopic balloon dilatation is one of the laparoscopic treatments.This paper analyze the factors influencing the prognosis of benign ureteral stricture which treated by retrograde balloon dilatation in ureteroscopy in retrospective study,in order to provide clinical guidance of ureteroscopic retrograde balloon dilatation for benign ureteral stricture,so that more urologists have deeper understandings on the balloon dilatation treating ureteral stricture.Methods: Patients with benign unilateral ureteral stricture who underwent retrograde ureteral balloon dilatation from October 2012 to October 2016 in urology department of The First Affiliated Hospital of China Medical University were retrospectively reviewed.A total of 40 patients,including 20 males and 20 females.Age ranged from 25 to 76 years.According to the cause of stenosis classification: 11 patients were inflammatory ureteral stricture,14 patients were caused after transurethral ureteroscopic lithotripsy,4patients were caused after ureteral bladder replantation,2 cases were caused after ureteropelvic junction.4 cases of gynecological pelvic stenosis,1 case caused by incarcerated stones,1 case was congenital ureteral stricture and 3 cases of unexplained stenosis.The position of the ureteral stricture was located at the ureteral pelvic junction in 12 cases,8 cases at the upper ureter,3 cases at the middle and 17 cases at the lower part.The length of the ureteral stricture was between 0.2cm to 2cm.All patients were treated with U30 ureteroscopic balloon dilation catheter,and F7D-J stent or hippocampus ureteral stent was left 1 year after operation.The stent was replaced every 3 or 4 months and Ultrasound and enhanced Computed Tomography Urography were examinated after extubation,and their clinical sympotom were followed up at the same time.Result: The operation time was between 45min-90 min,with an average of 60 min.Patients spend an average of 2.5 days in the hospital after operation.There was no severe complication,and the most common type of complications were hematuria and urinary tract irritation.During one year postoperative follow up,25 patients(62.5%)were successfully treated with ureteral stricture and 15 cases(37.5%)of treatment failure were observed.Of the 15 failure patients,one was treated by open surgery,4 cases continue replace D-J stent and others were not followed up anymore.Univariate Chi-square test and Multivariate logistic regression analysis showed that the length of ureteral stricture and the degree of hydronephrosis were the main factors affecting the prognosis of surgery(P <0.05),whereas the gender,age,location of ureteral stricture have no statistical significant(P> 0.05).Conclusion: Ureteroscopy balloon dilatation is a safe and effective surgical treatment for benign ureteral stricture due to its less complication,shorter operation time and shorter average hospitalization day.It should be the preferred option for cases of benign ureteral stenosis with mild degree of hydronephrosis within a narrow range of 1cm.But the indications of balloon dilation for the treatment of ureteral stricture should be strictly controlled... |
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