Ureteral strictures are caused by kidney stones, scar tissue, or cancerous growths. Mild cases can be treated with outpatient surgery, while severe cases may require more extensive surgical treatments such as excising scar tissue or repairing the ureter. Symptoms vary depending on the cause.
A ureteral stricture is a narrowing of the ureters. There are several causes for this condition, including cancerous growths, kidney stones, or the presence of scar tissue, within or around the ureters. If the cause of the stricture is benign, treatment is usually straightforward and may involve outpatient surgery. Severely blocked ureters or those that are blocked due to cancer require more extensive treatment.
In most cases, a ureteral stricture forms because the patient has had kidney stones. The stones themselves can cause strictures by lodged in the ureters, or they can injure the ureters as they exit the patient’s body, leaving behind scar tissue. Ureteroscopy, which is used to treat kidney stones, can also damage the ureters, which can cause scarring. Additionally, it is possible for a patient to develop intrinsic stricture due to cancer within the ureters.
Patients can also develop what is known as extrinsic stricture, which occurs when something outside the ureters presses against them. There are many possible causes for this, including scar tissue or swelling in nearby organs. Cancer of other organs can also lead to a stricture in the ureters if the tumor presses against one or both.
Symptoms of ureteral stricture can vary considerably from patient to patient, often depending on the underlying cause. A general feeling of sickness is common, as is pain in the lower back or abdomen. A patient may also experience nausea, vomiting and possibly fever.
Treatment depends on the severity of the condition. Mild cases can often be resolved with an outpatient surgical procedure in which a stent is inserted into the affected ureter. The stent holds the ureter open so urine can flow from the kidney to the bladder without obstruction. The stents can be worn for three months, after which they are removed or replaced.
More severe cases may require a variety of other surgical treatments. It may be necessary to excise scar tissue, either inside or outside the ureter. Rarely, the ureter itself may need to be repaired, often with a graft from the patient’s intestinal tract. If urine has accumulated in the kidneys, it may need to be removed by inserting a needle directly into the kidney and draining the fluid.
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