INTRAURETERAL METALLIC SELF-EXPANDING ENDOPROSTHESIS (WALLSTENT) IN THE TREATMENT OF DIFFICULT URETERAL STRICTURES

Intractable and recurrent ureteral stricture presents a continuous cha llenge to the urologist. We report on 5 patients with severe ureteral stricture who were successfully treated with self-expanding metallic s tents. Ureteral stricture occurred at ureteroileal anastomotic sites a fter neoplasm resection in 2 cases, multiple upper ureteral strictures were related to multiple surgical procedures for correction of bladde r exstrophy in 1 and a ureteral kink developed in 1. Treatment with tr ansluminal balloon dilation provided poor results but self-expanding m etallic stents were used successfully with no major complications. In the last patient the stent and the overlying ureter were removed due t o recurrent reflux; the gross and histological ureteral changes are di scussed in detail. The technical approach is described, alternative th erapeutic options are considered and pertinent literature is reviewed.