What is Ureteric Stricture?

A ureteric stricture is a narrowing of the ureter, the tube that carries urine from the kidney to the bladder. This narrowing obstructs urine flow, leading to hydronephrosis (swelling of the kidney), infections, and possible kidney damage if untreated.
Dr. Swapnil Gholap specializes in endoscopic, laparoscopic, and reconstructive management of ureteric strictures, offering safe and effective solutions tailored to each patient’s condition.

Causes of Ureteric Stricture

Ureteric strictures can be congenital (present from birth) or acquired (develop later in life). Common causes include:

• Previous surgeries on the urinary tract or abdomen

• Kidney stones causing chronic irritation or injury

• Trauma or instrumentation (catheter, stent placement)

• Infections such as tuberculosis or severe UTIs

• Radiation therapy to the pelvic area

• Tumors or external compression of the ureter

Symptoms of Ureteric Stricture

Patients with a ureteric stricture may experience:

• Flank or abdominal pain (due to back pressure on the kidney)

• Reduced urine output or interrupted flow

• Recurrent urinary tract infections (UTIs)

• Fever and chills (if infection develops)

• Blood in urine (hematuria)

• Nausea and vomiting from urinary blockage

• Swelling or discomfort on one side of the abdomen

When is Treatment Needed?

Dr. Swapnil Gholap may recommend treatment when:

• The obstruction is causing hydronephrosis or kidney damage

• Recurrent infections or pain are present

• The stricture length is significant and not suitable for simple dilation

• Conservative treatments (like stenting or dilation) have failed

• Kidney function is at risk due to long-standing obstruction

Treatment Options for Ureteric Stricture

The treatment approach depends on the location, length, and severity of the stricture:

1. Endoscopic Management –

   • Minimally invasive procedure using a ureteroscope and laser to remove or widen the narrowed section.

   • Ideal for short strictures.

2. Balloon Dilatation –

   • A small balloon is inserted into the ureter and inflated to stretch the narrowed area.

3. Ureteric Stenting –

   • A thin tube (stent) is placed to allow urine to flow freely while the ureter heals.

4. Laparoscopic or Robotic Ureteric Reconstruction –

   • For longer or complex strictures, the narrowed segment is removed and the healthy ends are reconnected.

5. Open Surgical Repair (Ureteroureterostomy or Ureteral Reimplantation) –

   • Performed when minimally invasive options are not feasible or for recurrent strictures.

Recovery & Aftercare

• Hospital stay – Usually 2–4 days, depending on the procedure.

• Stent removal – Typically done 3–6 weeks after surgery.

• Pain management – Mild discomfort or burning is common for a few days.

• Follow-up imaging – Ensures that urine is draining normally and no recurrence occurs.

• Hydration – Drink plenty of fluids to prevent infections and stone formation.

FAQs About Ureteric Stricture

1. Is ureteric stricture a serious condition?
Yes. If left untreated, it can cause kidney swelling, infections, and loss of kidney function. Early treatment prevents long-term damage.

2. How is ureteric stricture diagnosed?
Through ultrasound, CT urography, retrograde pyelography, or renal scans to assess urine flow and stricture location.

3. Is surgery always required?
Not always. Short or mild strictures may be managed with endoscopic dilation or stenting, but recurrent or long strictures often need reconstructive surgery.

4. How long is recovery after surgery?
Most patients recover within 2–3 weeks, with full return to normal activities in about a month.

5. Can ureteric strictures recur after treatment?
Yes, recurrence is possible. Regular follow-up and imaging help detect and manage any narrowing early.