Background: Ureteral strictures constitute an important clinical problem due to the increasing number of cases. Endoscopy has an established but limited role in the treatment of ureteral strictures. Endoscopic treatment of other than single, short strictures results in a high recurrence rate and treatment failure. Promising tools are metallic stents available now on the urological market; however, there are no standardized indications for the treatment of ureteral strictures with the use of metallic stents. Study aim was to determine the features influencing the results of the self-expanding ureteral stents (SUS)-assisted endoscopic treatment. The secondary endpoint was to relate the etiology of the stricture to the effectiveness of the SUS-related endoscopic treatment. Methods: In a retrospective, single-center study, we present our experience in implantation of 65 SUS in the treatment of ureteral strictures of different etiology. The assessment of the efficacy and safety of the treatment was performed by the author’s quality of life questionnaire, number of serious complications (Clavien-Dindo > 3a), patency of the SUS during stenting and the possibility of full recovery of the ureteral stricture with endoscopic methods assisted by the SUS. Uni- and multivariate regression models have been applied to define treatment failure predictors. Results: Effective treatment of ureteral strictures with the SUS can be achieved in patients with a short ureteral stricture which usually occur after point injury of the ureter, without significant thermal damage. In long ureteral strictures typical of inflammatory diseases, complications after radiotherapy, and extensive thermal damage, the treatment failure rate with the use of the SUS is high. Conclusions: Univariate analysis identified strictures longer than 2 cm, a dilatation diameter below 14 F and impaired stent patency during stenting as significant predictors of treatment failure, of which the possibility of an appropriately wide dilation and the patency of the SUS resulted from the length of the stricture.
Kowalski et al. (Tue,) studied this question.