Troubled by Ureteral Stricture? Try This New Approach

A New Option for Stent Implantation

Ureteral stricture often leads to hydronephrosis, recurrent infections and even renal function impairment in patients. While conventional long-term indwelling ureteral stents can relieve symptoms temporarily, they may cause considerable discomfort including frequent urination, urgent urination, hematuria and lumbago.

Recently, the urology team of Taikang Xianlin Drum Tower Hospital, Affiliated to Nanjing University Medical School, successfully performed ureteral balloon dilatation combined with metallic covered stent implantation to relieve the suffering of a patient plagued by ureteral stricture.

Operation photo of Director Ge Jingping (second from right)

The patient, Mr. Zhang, underwent surgery for ureteral calculi at another hospital one year ago, when ureteral stricture was detected during the procedure.

After the operation, Mr. Zhang had to keep a long-term indwelling ureteral stent to relieve obstruction caused by stricture. Over the past year, frequent stent replacements, persistent lumbar discomfort and urinary irritation symptoms greatly distressed him.

Mr. Zhang sought further treatment from Director Ge Jingping of the Department of Urology. The team attached high priority to his case and completed relevant examinations. Imaging results revealed multiple strictures in his left ureter.

After rigorous evaluation by specialists including Director Ge Jingping and Director Wang Longxin, Mr. Zhang was confirmed eligible for ureteral balloon dilatation plus metallic covered stent implantation.

Urography

MRI showing ureteral stricture segments

Unlike conventional long-term indwelling ureteral stents, metallic covered stents feature a larger lumen diameter, stronger supporting force, superior biocompatibility and longer indwelling duration.

"For complex ureteral strictures, especially patients who require long-term stenting yet suffer severely from associated side effects, metallic covered stent implantation is a favorable therapeutic option," stated Director Ge Jingping.

With support from the Anesthesia and Operation Center, Director Ge’s team first conducted fluoroscopic urography intraoperatively to locate the strictured segments of Mr. Zhang’s ureter. A ureteral balloon was used to dilate the strictures and restore basic patency of the lumen. A custom-made metallic covered stent was then precisely implanted to deliver durable and stable support for the narrowed ureter.

Postoperative urography confirmed restored patency of Mr. Zhang’s left ureter with the stent in proper position. He no longer needs frequent hospital visits for stent replacement and is free from urinary discomfort and lumbago.

In fact, treatment for ureteral stricture mainly depends on the location, severity and length of stricture, as well as split renal function and conditions of surrounding tissues.

Currently, mainstream treatments fall into two categories: endoscopic ureteral therapy and ureteral reconstructive surgery. Clinicians need to accurately weigh the pros, cons and indications of different therapies during diagnosis and treatment, so as to deliver personalized regimens for patients.

#UreteralStricture #Urology #MinimallyInvasiveSurgery #MetallicCoveredStent #RenalHealth #KidneyFunction