Evaluation of risk factors, treatment options, and prognostic‐related factors in patients with benign ureteral strictures: An 8‐year single‐center experience

Abstract

ObjectivesTo investigate the etiology, therapeutic effect, and prognosis‐related factors of benign ureteral strictures.MethodsWe analyzed the date of 142 patients with benign ureteral strictures from 2013 to 2021. Ninety‐five patients received endourological treatment and 47 patients underwent reconstruction. Preoperative, intraoperative, and postoperative information were compared and analyzed. Symptomatic improvement and radiographic blockage alleviation defined therapeutic success.ResultsStone‐related factors caused 85.2% of cases. The overall success rate of endourological treatment was 51.6% versus 95.7% of reconstruction (p < 0.01). However, endourological treatment was better in terms of postoperative hospital stay time, operation time, and intraoperative blood loss (p < 0.001). In endourological group, patients with stricture length ≤2 cm, mild‐to‐moderate hydronephrosis, proximal or distal stricture had a higher success rate. Multivariate regression analysis showed that the surgical method was the only independent risk factor affecting success and recurrence. Reconstruction success rate was higher than endourological treatment (p = 0.001, OR 0.057, 95% CI (0.011–0.291)), and recurrence rate was also lower (p = 0.001, HR 0.074, 95% CI (0.016–0.338)). No obvious recurrence was seen in reconstruction, and the median recurrence time in endourological treatment was 51 months.ConclusionsStone‐related factors are an important cause of benign ureteral strictures. Reconstruction is the gold standard treatment due to its high success rate and low recurrence rate. Endourological therapy is also preferred as the initial treatment in proximal or distal ureter with length ≤2 cm and mild‐to‐moderate hydronephrosis. Further close follow‐up is required after treatment.