Kurmanov T, Zhanbyrbekuly U, Zhexen Y
National Research Oncology Center, Nur-Sultan, Kazakhstan.
Urologiia. 2022 Sep(4):82-85.
The treatment of ureteral strictures is one of the most difficult problems of current urology. In recent years, an increase in post-radiation patients who have an iatrogenic ureteral damage during surgical procedures on the pelvic and abdominal organs is seen. We describe two cases in which a long ureteral stricture was diagnosed. The etiology of the strictures was associated with urolithiasis. After the removal of ureteral stones, long ureteral stricture developed in both patients. A nephrostomy tube was initially put. Considering the prolonged length of the stricture with a formation of obliteration, several treatment options were discussed, including nephrectomy. Nevertheless, due to the young age and the good functional state of the renal parenchyma, the decision was made about renal autotransplant, which was associated with a lower surgical risk. However, this procedure requires a high degree of training of the surgical team with appropriate experience.
输尿管狭窄的治疗是当前泌尿外科最棘手的问题之一。近年来,在盆腔和腹部器官手术过程中出现医源性输尿管损伤的放疗后患者有所增加。我们描述了两例诊断为长段输尿管狭窄的病例。狭窄的病因与尿路结石有关。两名患者在输尿管结石取出后均出现了长段输尿管狭窄。最初放置了肾造瘘管。考虑到狭窄段较长且形成了闭塞,讨论了多种治疗方案,包括肾切除术。然而,由于患者年龄较轻且肾实质功能状态良好,决定进行自体肾移植,该手术的手术风险较低。然而,此手术需要手术团队具备高度训练及适当经验。