Ureteral strictures

Reviewed by Michael Stifelman, M.D. and Ojas Shah, M.D.

The physicians of NYU Urology Associates are highly experienced in the use of minimally invasive procedures to relieve obstructions in the urinary tract and reconstructive urologic surgery to repair damage to the ureters.

More information on ureteral strictures

Definition, causes and risk factors

The ureters are tubes that normally carry urine from the kidneys to the bladder. A ureteral stricture is a narrowing of the ureter that results in an obstruction in the flow of urine.

Strictures can have several origins:

  • They may develop after treatment for another urologic condition. Individuals who have undergone ureteroscopic or percutaneous kidney treatment for stones or tumors, pelvic radiation therapy or urinary diversion surgery may develop ureteral strictures. After these procedures, scar tissue may obstruct the ureter.
  • Other surgeries in the vicinity of the ureters can cause stricture formation, such as gynecologic or vascular surgery procedures.
  • Strictures may occur after passage of kidney stones or as a result of certain cancers.
  • External traumatic injury can cause strictures.
  • In children, congenital anomalies may result in strictures (meaning that the anomaly is present at birth).

Symptoms and diagnosis

Symptoms of ureteral strictures can include flank and/or abdominal pain, nausea, vomiting, fever, infection, or sometimes an overall sensation of not feeling well.

Because ureteral strictures can have a number of causes, your doctor will ask about your medical history and may perform a variety of diagnostic tests to rule out different causes. Your doctor may visualize the stricture using X-rays, ureteroscopy, retrograde pyelogram or nephrostogram, ultrasound, CT scan, or MRI.

If your doctor determines that a tumor might be present, additional tests may be required to determine if it is malignant or benign.

Treatment

After determining the cause and location of your ureteral stricture, we will develop an individualized treatment strategy. At NYU Urology Associates, we focus on minimally invasive treatments for ureteral strictures whenever possible.

For strictures that develop shortly after external injury or after surgical injury, surgery may be the first choice of treatment. During surgery, your doctor will remove scar tissue and may surgically reconstruct your ureter in a different location and reconnect it to the kidney. Surgery may be open, laparoscopic or robotic. If the stricture is extensive, then tissue from another part of the body, such as the small intestine, may be used to help reconstruct the ureter.

For less severe or chronic strictures, endoscopy may be recommended. Here, a flexible tube is passed through the urethral opening and threaded up through the bladder into the ureters. The doctor then uses specialized surgical instruments or lasers to cut through the blockage. In some cases, a balloon may be used to dilate the ureter. A stent (a hollow tube) may be inserted to keep the ureter open after treatment for several weeks.

Because an obstructed ureter may lead to fluid retention in the kidneys (hydronephrosis), your doctor may need to drain the fluid through a procedure known as percutaneous nephrostomy, in which a needle is inserted through the back into the kidney to drain excess urine. A ureteral stent may also be put in place; this device can help drain urine directly from the kidney to the bladder, bypassing the point of obstruction or stricture.

Make an appointment with an NYU urologist who treats ureteral strictures


Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.