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Difficult Cases in Endourology pp 235–244Cite as

Ureteroscopy for Ureteral Strictures

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Abstract

Ureteral strictures may occur due to intrinsic or extrinsic causes. Intrinsic stricture is usually caused by benign pathologies such as iatrogenic trauma, schistosomiasis, tuberculosis, and ureteral endometriosis. On the other hand, extrinsic strictures are usually of malignant nature, the ureter is encased by primary or metastatic, or retroperitoneal tumors, and the situation can be aggravated by periureteral fibrosis, a long-term adverse event of previous chemotherapy or radiotherapy.

Iatrogenic ureteral injury is the most common cause of benign ureteral strictures. Gynecological procedures account for most of the injuries especially after introduction of laparoscopic surgery with hysterectomy accounting for more than half of the cases. Urologic procedures, notably ureteroscopy, were described mainly because of ureteral trauma from instrumentation, calculus impaction, and the use of larger semirigid ureteroscopes. General surgical procedures including vascular surgery then follow. It has been reported also following a variety of surgical procedures including sympathetic nerve bloc and thoracolumbar lateral revision instrumentation and fusion. Penetrating rather than blunt trauma is the most common and may be caused by gunshots or explosive devices shells.

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Authors and Affiliations

  1. Department of Urology, Urology and Nephrology Center, Mansoura University, El Gomhoria Street, Mansoura, 35516, Egypt

    Ahmed M. Harraz M.D., Ahmed M. Shoma M.D. & Ahmed A. Shokeir M.D., Ph.D., FEBU

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  1. Ahmed M. Harraz M.D.
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  2. Ahmed M. Shoma M.D.
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  3. Ahmed A. Shokeir M.D., Ph.D., FEBU
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Correspondence to Ahmed M. Harraz M.D. .

Editor information

Editors and Affiliations

  1. Fac. Medicine, Dept. Surgery, Kuwait University, Safat, Kuwait

    Ahmed M. Al-Kandari

  2. , Department of Urology, Muljibhai Patel Urological Hospital, Dr Virendra Desai Road, Nadiad, 387 001, India

    Mahesh Desai

  3. , Urology and Nephrology Center, Mansoura University, Gomhoria Street, Mansoura, 35516, Egypt

    Ahmed A. Shokeir

  4. , Urology and Nephrology Center, Mansoura University, Gomhoria Street, Mansoura, 35516, Egypt

    Ahmed M. Shoma

  5. , Smith Institute for Urology, Long Island Jewish Health System, New York, 11040, USA

    Arthur D. Smith

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Harraz, A.M., Shoma, A.M., Shokeir, A.A. (2013). Ureteroscopy for Ureteral Strictures. In: Al-Kandari, A., Desai, M., Shokeir, A., Shoma, A., Smith, A. (eds) Difficult Cases in Endourology. Springer, London. https://doi.org/10.1007/978-1-84882-083-8_24

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  • DOI: https://doi.org/10.1007/978-1-84882-083-8_24

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