Percutaneous endoscopic management of upper ureteral stricture size of stent.

PURPOSE

We determined the optimal size (6F versus 14/7F) of stent after endoscopic surgery based on clinical data.

MATERIALS AND METHODS

Between 1989 and 1993 we performed percutaneous endopyelotomy and endoureterotomy in 40 cases of ureteropelvic junction or upper ureteral strictures. The causes of stricture were primary in 20 cases, tuberculosis in 9, previous operation in 6 and others in 5. After endoscopic management we placed 6F internal stents in 25 patients (13 in primary and 12 in secondary cases) or 14/7F endopyelotomy stents in 15 patients (7 in primary and 8 in secondary cases) for 6 to 8 weeks (average 54.2 days). Coexisting stones or infundibular strictures were managed simultaneously. All patients have been followed for a minimum of 7 months postoperatively (range 7 to 55, average 38).

RESULTS

Overall success rate was 84% (92.3 in primary and 75% in secondary cases) with the 6F stent and 93.3% (85.7% in primary and 100% in secondary cases) with the 14/7F endopyelotomy stent.

CONCLUSIONS

The small number of patients in each group did not reach statistical significance. However, there was a definite trend for better results with the use of 14/7F stents in patients with secondary stricture (100% versus 75%), although the difference in success rates between 6F and 14/7F stents was not significant statistically (p = 0.13).