Frequently Asked Questions About Ureteral Stricture Reconstruction

A ureteral stricture is a narrowing of the ureter, the tube that carries urine from the kidney to the bladder. This narrowing restricts urine drainage and can cause kidney swelling (hydronephrosis), pain, infections, and potentially kidney damage if left untreated.

Common causes include prior urologic surgery, kidney stone passage, external trauma or injury, radiation therapy for pelvic cancers, inflammatory conditions, chronic infections, and ischemic injury from vascular problems. Some strictures are congenital.

Diagnosis typically involves imaging studies such as CT urography, ultrasound showing kidney swelling, retrograde pyelography, or nuclear medicine scans assessing kidney drainage. The location and length of the stricture help determine the best treatment approach.

Options include endoscopic balloon dilation, endoureterotomy (cutting the stricture), ureteral stent placement, ureteroureterostomy (removing the strictured segment and reconnecting), ureteral reimplantation, Boari flap reconstruction, and buccal mucosa grafting for complex cases.

Surgery time varies by technique and complexity. Simple reconnections take 2-3 hours. Complex reconstructions involving bladder flaps or grafts may take 3-5 hours. Most procedures require an overnight hospital stay.

Yes, a ureteral stent is typically required after surgery to maintain drainage and support healing. The stent usually remains in place for 4-6 weeks, sometimes longer for complex reconstructions. Stent removal is performed as an office procedure.

Success rates depend on stricture characteristics and surgical technique. Ureteroureterostomy achieves 90-95% success for short strictures. Complex reconstructions achieve 80-90% success in experienced hands. Long-term follow-up is important to monitor kidney function.

Yes, if untreated. Chronic obstruction can cause progressive kidney damage and eventually kidney failure. Early detection and treatment are important to preserve kidney function.