Document Detail

Long-term results of treatment for ureteroenteric strictures.
MedLine Citation:
PMID:  11744456     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To review the long-term outcome for ureteroenteric stricture treatment. METHODS: The ileal conduit diversions that formed ureteroenteric strictures from 1966 to 1999 were reviewed. The strictures were diagnosed radiographically, and malignancy was excluded. The treatment, location, length, diameter, and timing of stricture development after conduit creation was evaluated and compared regarding the time until stricture recurrence (failure). Success was defined as symptomatic improvement and radiologic evidence of patency. RESULTS: Forty patients, after exclusions, returned for ureteroenteric stricture repair, comprising 79 procedures (27 open repairs and 52 balloon dilations). The open repair had a success rate at 1, 2, and 3 years of 92%, 87%, and 76%, respectively. Seven of the open cases were preceded by failed dilations. Balloon dilation had a success rate at 1, 2, and 3 years of 15%, 15%, and 5%, respectively (P = 0.0001 versus open). Similar patency results for open versus balloon (P = 0.0001) were noted with analysis restricted to each patient's first stricture repair. Strictures greater than 1.0 cm were more likely to recur (P = 0.03). All strictures forming within 6 months of the conduit creation were treated with dilation and failed within 1 year. Of note, 11 of the 40 patients were found to have less than 25% renal function on the strictured side. CONCLUSIONS: Open repair for ureteroenteric strictures offers excellent long-term patency (76% at 3 years, P = 0.0001). On review, balloon dilation appeared to have less successful patency rates and was often followed by open repair after failure. Patients with a history of anastomotic strictures should be closely monitored to avoid renal damage and failure.
D S DiMarco; A J LeRoy; S Thieling; E J Bergstralh; J W Segura
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Urology     Volume:  58     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2001 Dec 
Date Detail:
Created Date:  2001-12-17     Completed Date:  2002-01-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  909-13     Citation Subset:  IM    
Department ofUrology, Mayo Clinic, Rochester, Minnesota, USA.
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MeSH Terms
Balloon Dilatation
Constriction, Pathologic / etiology,  therapy
Follow-Up Studies
Middle Aged
Multivariate Analysis
Ureteral Obstruction / etiology,  therapy*
Urinary Diversion / adverse effects*

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