PERCUTANEOUS ENDOSCOPIC MANAGEMENT OF UPPER URETERAL STRICTURE - SIZEOF STENT

Purpose: We determined the optimal size (6F versus 14/7F) of stent aft er endoscopic surgery based on clinical data. Materials and Methods: B etween 1989 and 1993 we performed percutaneous endopyelotomy and endou reterotomy in 40 cases of ureteropelvic junction or upper ureteral str ictures. The causes of stricture were primary in 20 cases, tuberculosi s in 9, previous operation in 6 and others in 5. After endoscopic mana gement we placed 6F internal stents in 25 patients (13 in primary and 12 in secondary cases) or 14/7F endopyelotomy stents in 15 patients (7 in primary and 8 in secondary cases) for 6 to 8 weeks (average 54.2 d ays). Coexisting stones or infundibular strictures were managed simult aneously. All patients have been followed for a minimum of 7 months po stoperatively (range 7 to 55, average 38). Results: Overall success ra te was 84% (92.3% in primary and 75% in secondary cases) with the 6F s tent and 93.3% (85.7% in primary and 100% in secondary cases) with the 14/7F endopyelotomy stent. Conclusions: The small number of patients in each group did not reach statistical significance. However, there w as a definite trend for better results with the use of 14/7F stents in patients with secondary stricture (100% versus 75%), although the dif ference in success rates between 6F and 14/7F stents was not significa nt statistically (p = 0.13).