Analysis of risk factors for relapse of ureteric strictures after endoureterotomy
Popov S.V.1,2, Chernysheva D.Yu.1,2, Orlov I.N.1, Skryabin O.N.1,2
1 St. Luca’s Clinic, Saint-Petersburg
2 Saint-Petersburg State University
Stricture of the ureter is a decrease of ureteral opening of various genesis, characterized by functional obstruction of the upper urinary tract. To date, most authors recognize the effectiveness of endoscopic dissection of ureteric strictures. The main disadvantage of the endoureterotomy method for eliminating unextended ureteric strictures is a large percentage of relapses after treatment.
Aim: to study the factors affecting the long-term effectiveness of endoureterotomy
Patients and Methods: prospective analysis of endoscopic treatment of 148 patients with unextended ureteric strictures in the period from 2007 to 2016 in St.Luca’s Clinic, Saint-Petersburg. The median age was 48 (34; 60) years. The factors affecting the long-term outcome of endoureterotomy were identified and analyzed, depending on the presence or absence of relapse of the disease within 12 months after intervention. All patients were operated on and underwent endoscopic dissection of ureteral strictures.
Results: the overall effectiveness of endoureterotomy was 75.0%. Factors significantly affecting the relapse of ureteric strictures were identified: HbA1c> 7.5% at the time of surgical treatment (RR = 6.2, p<0.05), nephrostomy tube (RR = 2.8, p<0.05), pyelonephritis in the anamnesis (RR = 2.2, p<0.05), keloid scars (RR = 2.9, p<0.05). In addition, the radiation-induced strictures or the recurrent nature of the disease increase the risk of an adverse outcome of endoureterotomy by 13 and 6.5 times, respectively (p<0.05).
Conclusion: the analysis of risk factors for relapse of ureteric strictures and their further study will improve the treatment strategy for patients with unextended ureteric strictures and optimize indications for endoureterotomy.
Key words: ureteric stricture, endoureterotomy, nephrostomy drainage, relapse, risk factors.
For citation: Popov S.V., Chernysheva D.Yu., Orlov I.N., Skryabin O.N. Analysis of risk factors for relapse of ureteric strictures after endoureterotomy // RMJ. Medical Review. 2018. № 2(I). P. 13–15.
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