Ureteral stricture refers to the narrowing of the ureteral diameter, which affects urine excretion. Common causes of the disease include congenital narrowing of the ureteropelvic junction, long-term conditions such as ureteral stones and inflammation, or surgical-induced strictures.

bubble_chart Clinical Manifestations

1. Affected side lumbago, sometimes a hydronephrotic kidney can be palpated.
2. When complicated by infection, there may be fear of cold fever or pyuria.
3. Bilateral ureteral stenosis may present with uremic symptoms.

bubble_chart Auxiliary Examination

1. For general cases, checking box limit "A" is sufficient.
2. For complex or undiagnosed cases, additional examination items from box limits "B" and "C" can be included.

bubble_chart Diagnosis

Symptoms and signs

1. Early or grade I stenosis is often asymptomatic. Severe stenosis causing hydronephrosis may lead to lumbago, and the kidney may be palpable.
2. If there is a ureteral stone, renal colicky pain and hematuria may occur.
3. When combined with infection, fever and lumbago may be present, with red and white blood cells in the urine, and bacterial growth in urine culture.

X-ray examination

1. Plain radiograph of the urinary system. Observe whether there are stones in the urinary system and whether the shadows of both kidneys are enlarged.
2. High-dose intravenous urography. Observe the location and degree of ureteral stenosis, as well as the extent of hydronephrosis.
3. Retrograde urography. During ureteral catheterization, the presence of obstruction can be confirmed, and the location and degree of stenosis can be clearly visualized.

bubble_chart Treatment Measures

1. For mild cases, ureteral dilation can be performed.
2. In cases of ureteropelvic junction stenosis with preserved renal function, resection of the stenotic segment and pyeloplasty may be performed.
3. For limited ureteral stenosis, resection of the stenotic segment and end-to-end anastomosis can be performed.
4. Stenosis of the lower ureter may be treated with ureteral reimplantation into the bladder.
5. For extensive ureteral stenosis with preserved renal function, ileal ureter replacement should be performed.
6. For infection prevention, "Category A" drugs should be used first.
7. If infection is already present, "Category B" or "Category C" drugs may be used to control the infection.
8. Generally, intramuscular or intravenous administration routes are selected. To protect renal function from damage, drugs with high nephrotoxicity should be avoided or used with caution.

bubble_chart Cure Criteria

1. Cure: Ureteral stenosis relieved, kidney infection controlled, intrarenal pelvic pressure returned to normal (within 10cm H2O).
2. Improvement: Postoperative ureteral patency remains suboptimal, intrarenal pelvic pressure >15cm H2O.
3. Uncured: Ureteral stenosis persists, nephrostomy tube cannot be removed.