FACTORS INFLUENCING LONG-TERM RESULTS OF TRANSLUMINAL DILATATION OR ELECTROCAUTERY INCISION WITH STENTING OF URETERAL OR URETEROPELVIC JUNCTION STRICTURES

This retrospective study analyses the results of 129 transluminal ball oon dilatations, and 38 endopyelotomies and endoureterotomies, of stri ctures of the ureter and ureteropelvic junction, performed from 1977 t o 1989 (a total of 192 patients, 25 lost to follow-up). The results we re assessed over a follow-up period of at least 4 and up to 14 years, and stratified according to demographic criteria (location and length of stricture), aetiology (benign versus malignant) and viability, i.e. vascular supply to stricture and adjacent ureter. The success rate fo r endopyelotomy and endoureterotomy in non-neoplastic lesion was 90%. The success rate of transluminal balloon dilatation was 83% in short s trictures with intact vascular supply but only 30% in strictures with compromised vascular supply. For lesions with compromised vascular sup ply with underlying malignant aetiology, the rate of failure of transl uminal balloon dilatation was 92%. Based on this experience: endopyelo tomy and endoureterotomy are recommended for strictures of the ureter or ureteropelvic junction with underlying non-neoplastic aetiology; tr ansluminal balloon dilatation is recommended for short ureteric strict ures with intact vascular supply and non-neoplastic aetiology; permane nt stents are recommended for strictures with uncontrolled neoplastic disease and compromised vascular supply; and surgical interventions ar e recommended for all other strictures with compromized vascular suppl y.