Stricture

Stricture is synonymous with treatment failure. Clinical manifestations include flank pain, and/or continued obstruction on radiographic studies. Diuretic renography can confirm functional obstruction. Intravenous pyelogram may show delayed excretion of contrast.

Endopyelotomy, either antegrade or retrograde, may be used to treat stricture of the ureteropelvic junction. Ultimately, open dismembered pyeloplasty may be necessary to treat recalcitrant secondary ureteropelvic junction obstruction.

Risk factors for stricture formation include previous irradiation, previous surgery on the ureteropelvic junction, and devascularization of the ureteral segment. Prevention relies on having a sound tension-free anastomosis at the time of surgery.

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