The Role of Endourologic Management for Tuberculous Ureteral Stricture

Park, Hyun Jun; Shin, Ki Yong; Lee, Tchun Yong

Abstract

PURPOSE: Tuberculous ureteral stricture causing a progressive obstructive uropathy is a common complication of renal tuberculosis. The aim of our study was to evaluate the effectiveness of early ureteral stenting or percutaneous nephrostomy (PCN) in patients with tuberculous ureteral stricture.
MATERIALS AND METHODS
Seventy seven patients (84 renal units) with tuberculous ureteral strictures were analysed respectively. We evaluated the final outcome of involved kidneys according to the two different managements; medication only versus medication plus ureteral stenting or medication plus PCN.
RESULTS
In our series, nephrectomy rate was about 51%. In cases treated with medication only, the nephrectomy rate was about 73%. While the nephrectomy rate was about 34% when treated with medication plus early ureteral stenting or PCN. The rate of reconstructive surgery for ureteral strictures was significantly different between the cases treated with medication only (8%) and medication plus early ureteral stenting or PCN (49%). Moreover, spontaneous resolution of the ureteral strictures was noted in 6 out of 12 renal units which had strictures in the course of medical therapy and were managed with early ureteral stenting.
CONCLUSIONS
Early ureteral stenting or PCN in patients with tuberculous ureteral stricture may increase the opportunity for later reconstructive surgery and decrease the possibility of renal loss.