DILATION OF LOWER URETERAL STRICTURES WITH VANANDEL CATHETERS

We present a simple method to dilate ureteral strictures, which was pe rformed in 7 patients with metastatic cancer (1 breast, 1 lymphoma, 2 ovarian and 3 colorectal tumors) who presented with newly discovered o bstruction in the distal ureter. The obstruction was due to tumor in t he pelvis in 5 patients and to pelvic radiotherapy in 2. A 0.035-inch guide wire was passed beyond the stricture cystoscopically. In each ca se a double pigtail stent could not be passed beyond the stricture ove r the guide wire. The strictures were then dilated with progressively larger Van Andel catheters passed over the guide wire through the cyst oscope. Following dilation a 7.5F to 8.5F soft double pigtail catheter was easily advanced. All patients had good drainage on followup radio graphic studies. The method is presented as an alternative to balloon dilation of lower ureteral strictures when the goal is placement of an adequate diameter indwelling ureteral stent.