ENDOSCOPIC MANAGEMENT OF URETERAL STRICTURES

Purpose: We investigated and defined the role of endourological method s in the treatment of patients with ureteral stricture. Materials and Methods: A literature search was performed of the MEDLINE data base fr om 1978 through August 1996 concerning endoscopic treatment of patient s with ureteral strictures. Additional articles from before 1978 were also selectively included. Results: Many endourological methods are av ailable to treat patients with ureteral strictures. Ureteral dilation via an antegrade or retrograde approach may be accomplished in most ca ses with varying rates of success depending on stricture etiology, loc ation and length. Endoscopic ureterotomy may also lead to long-term pa tency in select cases and appears to be superior to dilation alone in patients with anastomotic ureteral strictures. However, no randomized studies comparing endourological methods in the treatment of ureteral stricture disease were found. Conclusions: Significant advances in tec hnique and technology have led to an improved ability to treat uretera l strictures without the need for open surgery in many patients.