EVALUATION OF DIFFERENT ENDOUROLOGICAL TECHNIQUIES FOR MANAGEMENT OF PATIENTS WITH BENIGN URETERAL STRICTURE

Abstract

. degree of suspicion and clinical sense for early diagnosis as well as special skills for proper treatment. The etiology of stricture ureter may be congenital, or acquired (traumatic, post inflammatory, neoplastic and miscellaneous). In our country, bilharziasis is accused as the most common cause for primary ureteral stricture. With a similar importance is iatrogenic ur teral stricture whether secondary to open sut:geryor ureteral endoscopy. Detailed clinical history and curious• physical examination are important for diagnosis of ureteral stricture and determination of the most possible cause. However, definite diagnosis requires more than one radiological test to prove obstruction of the upper urinary tract and delineate the site of stricture. Intravenous urography is still considered the comer stone in diagnosis of ureteral stricture. Radioisotope scanning of the kidney may help to define equivocal obstruction, however, it can not determine either site or length of ureteral obstruction. It is important to define the exact • site as well as the length of strictured segment as it will affect the treatment modality. As such retrograde ureterography has a fixed role in diagnosis of ureteral stricture and in most of the studies the te hnique is performed at the time of endoscopic treatment of ureteral stricture. • Surgical treatment of ureteral stricture depends on the site, length and

type of stricture. Many surgical procedures are available for correction and range from simple uretero-ureterostomy to ileal replacement and renal auto­ transplantation. Recently, endoscopic treatment, either antegrade or retrograde, of ureteral stricture becon,es an established technique. Either endo-dilatation or endo-incision are used to cut the strictured segment