Surgery is one of the best treatment options for ureteric strictures. Though this condition can be treated with medicines, surgery just ensures a quicker treatment timeline and recovery from your strictures. Plus, the surgeries you need are not open surgeries. They are highly specialized minimally invasive surgeries, which can even be performed on an outpatient basis. They allow you to recover quickly and have minimal risks.  Surgery as a whole can be scary, but if you choose to get them from an experienced institution like MASSH, it can help you understand all the risks and processes beforehand. This will help you enter the OR with all the information and confidence you need. Now that you know the basics of ureteric stricture surgery, let’s learn more about ureteric stricture laparoscopic surgery and ureteric stricture surgery recovery.

4 Top Ureteric Stricture Surgery Options
 

1. Ureterorenoscopy

Ureterorenoscopy is one of the most popular treatment processes for ureteric strictures. This is mainly because the procedure is very safe, effective, and has low risks involved. It is effective in treating strictures of all sizes and can be a permanent cure for your strictures if you get it from a top institution like MASSH. Here’s how the procedure is performed.

• The surgery is done under general anesthesia where the patient is unconscious for the duration of the procedure. Even though it is a minimally-invasive surgery, no actual incisions are made into the body of the patient. The surgical tools and the camera (ureteroscope) are inserted into the urethra of the patient and transported to the ureter through the bladder.
   
• Once the visuals are achieved of where the stricture exists, doctors can use a variety of surgical tools to either cut out the stricture or vaporise it with lasers. This frees up the blocked ureter and clears out the urine flow out of the body. The use of lasers or surgical tools depends on the discretion of your surgeon and the available infrastructure where you are getting the procedure.
   
• Laser removal is the best option for ureterorenoscopy because it is highly directed and doesn’t damage nearby tissues. The low chances of nearby damage can be a great plus point in ensuring that you don’t get strictures again.
   
• One of the key things about this procedure is that it uses a generous amount of lubrication to ensure that inserting the camera and tools through your urethra doesn’t damage your interiors in any way.
   
• Once the procedure is complete, patients can go home the next morning if doctors need to monitor the recovery of the patient.

Ureterorenoscopy is one of the best surgical treatment options for ureteric strictures, but it requires an experienced and qualified specialist to perform this surgery flawlessly. You also need to get it from an institution that can offer the necessary low-risk infrastructure to ensure a successful surgery with minimal recurrence risk.

2. Balloon Dilation

Balloon dilation is one of the easiest and quickest ways to get rid of your ureteric stricture. This procedure is performed on an outpatient basis and does not even require general anaesthesia. However, one of the key limitations of balloon dilation is that it can’t effectively treat strictures that are larger than a cenitmetre in length. If your stricture is under that, this procedure can help you get rid of your strictures once and for all.

• The procedure involves inserting a balloon into the urethra of the patient and having it travel inside the body up into the ureter through the bladder. Local anaesthesia is used on the patient, and this procedure can even be performed in the doctor’s office.
• Using a camera, the doctors locate the stricture inside the ureter and then blow up the balloon. The inflation slowly widens the ureter and allows for the passage of urine. It also reduces and clears out the stricture in the process.
• Balloon dilation is a simple procedure, and while it has limitations, it is still very useful in helping patients get relief from their symptoms. Because of its ease and low risk, doctors can often recommend getting multiple dilations to clear out even bigger strictures. However, that comes with a larger risk. Every time this procedure is performed, the risk of contracting an infection is there, which can cause recurring strictures.

The risk of damaging the ureter or any internal part of your urinary tract during the procedure always remains. This is why you should get your procedure done by experienced doctors from reputable institutions like MASSH.

3. Percutaneous Ureterorenoplasty (PCN)

PCN is one of the more serious procedures for ureteric stricture that is reserved for advanced and complex strictures. If a patient has multiple large strictures or the urine flow is cut off to a great extent, PCN is prescribed to them. This procedure can be performed in different ways, and it has different risk factors based on the surgical method that is chosen. Regardless of the risk, this is, however, one of the best and most permanent treatments for strictures. So first, let’s understand what the two different approaches to this procedure are, and then let’s understand how they work.

PCN can be performed both as a laparoscopic surgery or as an open surgery. Open surgery is more risky and requires a longer recovery period, complete with a considerable hospital stay. Laparoscopic surgery involves making a number of small incisions into the body to insert the surgical tools and perform the operation with minimal scarring and risks. This type of surgery has a lower risk and recovery time. However, it is more complex and requires an experienced doctor to perform. Now that you know about the different types, let’s learn about the procedure.

• An incision is made on the skin to insert the camera. In the case of open surgery, doctors just make one larger incision and use that to look inside the body directly.
   
• Once the visuals confirm where the stricture is, doctors either cut away that part of the ureter or use lasers to vaporize the stricture. For laparoscopic surgery, several small incisions are made to insert the surgical tools inside the body. That is not needed in case of an open surgery, where the tools are directly used inside the open incision.
   
• In some cases, if the stricture is cut out, tissues from other parts of the body can be grafted in place to ensure a quick and easy recovery for the patient. Generally, oral tissues are chosen for grafting purposes.
   
• The procedure can require an overnight stay at the hospital, but it is a surefire treatment for your strictures. The risk of recurrence always stays because the strictures can be formed even years later. However, if you get the surgery from reputable institutions, you can reduce the recurrence chances.

PCN is an extensive surgery, which may even need a few days of hospital stay for patients to recover fully. Even when the patient is discharged, they need to follow post-operative care tips for some time to ensure the risk of infections and recurrence is mitigated.

4. Stent Placement

Stents are a temporary solution to ureteric strictures, but when they are inside your body, they are 100% effective in helping you recover from your symptoms. How long the stent is kept inside your body differs based on your case. The stents are made of biocompatible materials, so it doesn’t cause any harm to your ureter as is. While the stent is being placed, the ureter wall can be damaged, which increases the risk of stricture recurrence, but it is a risk that can be managed. Here’s how the procedure is performed.

• Stent placement is a minimally invasive procedure that involves inserting the stent and camera through the urethra of the patient. No skin incisions are required for this surgery.
   
• Once the stent is navigated to the stricture, it is placed there to keep the ureter from collapsing around it. In some cases, the stents are laced with medicine, which keeps the ureter from collapsing in that area in the future too.
   
• For placing a stent, doctors check the length and location of the stricture first, and then a custom stent based on the case is built and placed inside the ureter.
   
• The stent ensures an easy pathway for urine, ensuring complete treatment of your symptoms at the earliest.

Stent placement procedures are performed under general anesthesia but offer quick recovery and discharge from the hospital. Following the post-operative care procedures will help you mitigate any risk of recurrence or infections, allowing you a solid temporary solution to your strictures.

Conclusion

Ureteric stricture surgery is one of the best ways to treat the condition. These surgeries are relatively safe and have limited risks and complications. The only thing you need to do is get your surgery from the top institutions like MASSH, which are experienced and well-equipped to perform these surgeries. At MASSH, we offer holistic care for all our patients ensuring minimal risk of recurrence and infections post-surgery. Our team of doctors and experts are well-experienced at handling all types of ureteric stricture surgeries. For more information, check out our website or visit us today.