Management skills of intractable ureterostenosis under ureteroscope
- Author:
Ji-Zhong REN
1
Author Information
1. Department of Urology
- Publication Type:Journal Article
- Keywords:
Intractable cases;
Therapy;
Ureteroscopy;
Ureterostenosis
- From:
Academic Journal of Second Military Medical University
2010;28(8):871-874
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To discuss the management principles and skills for treatment of intractable ureterostenosis under ureteroscope. Methods: Our management experience on 19 patients with intractable ureteral stenosis was retrospectively analyzed. The 19 cases included urological TB-caused multiple ureteral stenosis, oncothlipsis to ureters from intestinal tract or gynecology, restenosis 3 months to 12 years after pelviureteric junction plasty, operative site stenosis after ureterolithotomy, double ureter back flow accompanied by stenosis, ureter imperforation after renal parenchyma lithotomy without placing double "J", ureter imperforation 3 months after extracorporeal shock-wave lithotripsy due to ureterolith, tubal bladder stoma stenosis after renal transplantation, restenosis after tubal bladder stoma due to distal ureterostenosis, and so on. All the patients were treated under ureteroscope. The management methods included: the Wolf 8/9. 8 CH12° and Wolf 6/7. 6 CH5° ureteroscope was used as a dilator to dilate the stenoses; balloon expanding under ureteroscope was used to dilate the stenoses; the ureter pliers was used to expand the stenoses to different directions; the cold knife was used to open the stenoses; if the diameter of stenoses were smaller than the that of the ureteroscopes, F4. 5 or F3 double "J" tubes were inserted guided by a wire under ureteroscope; and 2 or 3 weeks later, a larger tube or two tubes were introduced into the stenoses already dilated partly by the former tube. Results: Ureteroscopic method failed in treating 2 patients in our group and succeeded in treating all the other patients. The outcomes of patient were fine during 2 months to 3 years' follow-up. Conclusion: It is difficult to treat patients with intractable ureterostenoses. With good experience in manipulation of ureteroscope, the flexible application of several techniques according to the different conditions of different patients can guarantee successful treatment in most patients.
