Endoscopic intervention of ureteric stricture: how have we been doing in the past 10 years?

Abstract

Objective: To examine the outcome ofendoscopic intervention of ureteric stric-ture and identify the factors affectingoperative outcomes.Patients and Methods: We retrospectivelyreviewed data of patients underwent endo-scopic intervention of ureteric stricture inthe period between January 2006 and June2016 in Queen Mary and Tung WahHospitals. Primary endpoint was stricturerecurrence, defined as radiological evi-dence of persistent obstruction, and/or theneed of drainage of the obstructed system.Results: During the studied period, endo-scopic intervention was performed on 83renal units in 64 patients. Majority (60%)of strictures were urolithiasis-related. Bal-loon dilatation was most commonly used(61%). Outcome was not significantly different among serial dilatation, balloondilatation, laser stricturotomy and combi-nation of techniques. The overall 1-yearand 5-year recurrence-free survival (RFS)was 50% and 44% respectively. Second ormore attempts had poorer outcome thanfirst attempt (5-year RFS 24% vs. 59%,p = 0.03). Urolithiasis-related stricture hadlower recurrence rate than stricture ofother aetiology (5-year RFS 66% vs. 28%,p = 0.00); while stricture length, stricturelevel, endoscopic intervention technique, orpre-operative renal unit differential func-tion had no association with recurrence.Conclusion: It is reasonable to firstattempt endoscopic intervention forurolithiasis-related ureteric strictures. Stric-tures of other aetiology, however, had pooroutcome if managed endoscopically.