Department of Urology, Uro-Oncology, Robot Assisted and Reconstructive Urologic Surgery, University Hospital Cologne, Cologne, Germany.
Department of Urology, Medical University Vienna, Austria.
Curr Opin Urol. 2021 Mar 1;31(2):170-176. doi: 10.1097/MOU.0000000000000849.
The purpose of this article is to outline the various therapeutic options of ureteral strictures.
Ureteral strictures with consecutive hydronephrosis can be due to endourological and surgical procedures, inflammatory processes, radiation therapy as well as spontaneous passage of ureteral calculi. When planning surgical correction, stricture length, anatomical location as well as patients' characteristics like age, comorbidities and previous treatment in the peritoneal cavity, retroperitoneum or pelvis should be taken into consideration. Treatment options include not only surgical reconstruction techniques like simple stricture excision, end-to-end anastomosis, ureterolysis with omental wrapping, ureteroneoimplantation, renal autotransplantation and ureter-ileum replacement, but also minimally invasive procedures such as self-expandable thermostents and pyelovesical bypass prosthesis.
Various therapeutic options can be offered in the treatment of ureteral strictures, potentially leading to long-term success rate of more than 90% and a rate of significant complications < 5%.
本文旨在概述输尿管狭窄的各种治疗选择。
伴有连续肾积水的输尿管狭窄可由腔内泌尿外科和外科手术、炎症过程、放射治疗以及输尿管结石的自发排出引起。在计划手术矫正时，应考虑狭窄长度、解剖位置以及患者的年龄、合并症和既往在腹膜后腔、后腹膜或骨盆中的治疗等特征。治疗选择不仅包括外科重建技术，如单纯狭窄切除、端端吻合、带网膜包裹的输尿管松解、输尿管再植入、肾自体移植和输尿管-回肠替代，还包括微创介入治疗，如自膨式热支架和肾盂膀胱旁路假体。
在输尿管狭窄的治疗中，可以提供各种治疗选择，潜在地导致长期成功率超过 90%，严重并发症发生率<5%。
