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  • Title: Holmium laser endoureterotomy for benign ureteral stricture: a single center experience.
    Author: Gnessin E, Yossepowitch O, Holland R, Livne PM, Lifshitz DA.
    Journal: J Urol; 2009 Dec; 182(6):2775-9. PubMed ID: 19837432.
    Abstract:
    PURPOSE: We assessed the long-term outcome of laser endoureterotomy for benign ureteral stricture. MATERIALS AND METHODS: From a database of 69 patients who underwent retrograde laser endoureterotomy from October 2001 to June 2007 we identified 35 with a benign ureteral stricture. Clinical characteristics, operative results and functional outcomes were investigated. Success was defined as symptomatic improvement and radiographic resolution of obstruction. RESULTS: Median followup was 27 months (range 10 to 72). All except 1 patient were followed at least 16 months. All patients completed clinical followup and 33 completed imaging. Of 35 patients 29 (82%) were symptom-free during followup and 26 of 33 (78.7%) were free of radiographic evidence of obstruction. All except 1 failure occurred within less than 9 months postoperatively. The success rate was higher for nonischemic strictures (100% vs 64.7%, p = 0.027) and tended to be higher for strictures 1 cm or less (89.4% vs 64.2%, p = 0.109). CONCLUSIONS: Holmium laser endoureterotomy is effective for benign ureteral stricture in well selected patients. Most failures occur within less than 9 months after surgery, which may indicate a need for closer followup during postoperative year 1. Factors that might may outcome are ischemia and stricture length.
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