Ureteric strictures, by their very nature, come with a risk of recurrence. In most cases, the recurrence can be caused by postoperative complications or other seemingly unconnected health concerns. However, it is important to note that the recurrence can be battled. While there is no dedicated medical treatment process, a thorough study of ureteric stricture causes and treatment has led to breakthroughs that have made ureteric stricture recurrence prevention a reality today. While it is not a perfect process, following the guidelines can help you at least mitigate some of the risk factors. So, let’s take a look at ureteric stricture complications and coping strategies to understand how you can prevent recurring strictures.

Symptoms of Recurrent Ureteric Strictures You Should Look Out For

Ureteric strictures are a slippery slope, once you have them, the first and most important thing for you is to get yourself treated. However, once you do go through treatment, you open yourself up to the risk of recurrence. Why? Because any surgery or procedures performed on your urinary tract is a major risk factor for ureteric strictures. Plus, surgeries open up the risk of infections, which again are risk factors for ureteric strictures. So, what should you do? Should you not get treatment at all?

No, absolutely not. Not getting the condition treated would in most cases severely damage your kidney over time. It could even lead to your death if left untreated and undiagnosed. So, the key is to focus on ureteric symptoms and management to ensure you can identify problem signs early and get them treated as soon as possible. Here are all the symptoms you need to check out.

Urinary Tract Infections (UTIs)

UTIs are one of the primary causes of ureteric stricture recurrence and they are also one of the early symptoms of the condition. If you have already had treatment for ureteral strictures and then you start exhibiting any of the following signs, you should go for medical help.

• Increased urinary frequency
• Pungent odour in urine with a dark or cloudy colour
• Needing to urinate more than twice at night
• Burning or sensation of pain during urination

These symptoms can be a quick and easy way to diagnose infections and their underlying cause.

Lower Back Pain

If you have a history of ureteral strictures and then you suddenly start having lower back pain again after your treatment, it may be a sign that the strictures are recurring. Make sure you check out the following signs of your back pain to get a better understanding if the pain is caused due to urinary tract problems or not.

• Pain that comes in waves and is dull
• Nausea and vomiting combined with dehydration
• Pain that radiates from your lower back to your groin area

These are some of the easily understandable signs that the pain you are experiencing is due to urinary tract problems. You should get medical help immediately to understand the cause of the pain and treat it.

Difficulty Urinating

As simple as it is, one of the primary signs of ureteral strictures is having difficulty urinating. If you have already had treatment, and you are having trouble urinating after that, it can be a sign of stricture recurrence. Here are some ways difficulty urinating can point towards ureteric strictures.

• Difficulty maintaining a steady stream of urine
• Difficulty in starting a urine stream
• Pain during urination

These are some of the common signs that you should look out for as they can directly point towards ureteral stricture recurrence. Getting a medical check-up is crucial if you are having any of these symptoms.

How Are Recurrent Strictures Diagnosed & Treated?

Once you start exhibiting any of the symptoms mentioned above, doctors use various diagnostic tests (both invasive and noninvasive) to understand the underlying cause. If in fact, the causes are strictures, there’s nothing to worry about, ureteric stricture diagnosis and treatment options exist to ensure that your condition can be treated and kept in check. So, let’s look at some of the tests used for diagnosing the symptoms and how the recurrent strictures are treated again.

Diagnosis

Diagnosing recurrent strictures is a bit different from diagnosing them for the first time. Invasive diagnostic procedures can make the condition worse or create new injuries that can lead to strictures again in the future. So, a special focus is laid on lab and imaging tests so as to not disturb the condition further. Here are some of the tests that are commonly used

• Urinalysis: Urine samples are collected from the patient and tested for their composition. Any abnormalities in the composition can indicate problems such as strictures. Urinalysis is a preliminary test and is generally ordered with other imaging tests.
   
• X-ray: Doctors use X-rays to see inside your body and find any stricture in your ureter. To help, they often use a contrast fluid to properly see the location and or size of the stricture.
   
• CT Scan: Similar to X-rays, CT scan tests are also used to diagnose ureteric strictures by looking at your ureters. Given the test is non-invasive, it does not increase your risk of recurrence again.

Treatment

Once the condition is diagnosed, the treatment needs to be continued again. Based on the location and length of the stricture the treatment options are presented. Here are some of the most common treatments used to treat recurring ureteric strictures.

• Stent Placement: Though it is a temporary solution, ureteric stenting for recurrent strictures is actually one of the best ways to keep yourself safe from recurrence. It is highly effective in cases where the UTIs can’t be contained or there are other conditions that are affecting your urinary health. Stent placement is an easy procedure and it can help you ensure easy and proper flow of urine from your ureters.
   
• Ureterorenoscopy: URS is an aggressive procedure but it can help you get a permanent solution from ureteric strictures. This procedure cuts out a part of the ureter that is having strictures and if needed, oral tissue (in most cases) is grafted in its place to treat the strictures. However, as an invasive procedure, it has its risks. So, it is crucial that you get your procedure done from reputable institutions like MASSH that can offer experienced doctors that are trained to perform this procedure perfectly.

How To Prevent Recurrent Ureteric Strictures?

Ureteric strictures can be prevented by taking certain precautions after your initial treatment. Postoperative care is crucial for helping patients keep the risk of recurrence low. Here are some of the best recovery tips that can help you prevent ureteric strictures.

• Keep yourself away from heavy physical activity for some time. Whether at home or at work, if you have had ureteric stricture treatment, it is best that you stay away from physically challenging work for some time. Your doctor will generally advise you to keep away from physically strenuous activities for at least a few weeks up to a few months after your surgery based on your case.
• Add antioxidant-rich food items to your diet like vegetables and fruits to keep your body safe from any type of postoperative infections.
• Make sure you follow the doctor’s orders in terms of any medications prescribed and have them regularly as and when prescribed.
• Wear scrotal supports or jockstraps if the doctor asks you to. It will help you recover quicker and better.
• Practice safe sex after your treatment to keep yourself safe from STIs and STDs.

Conclusion

Recurrent ureteric strictures are treatable but it requires determination and discipline from the patient’s end. However, they also need world-class medical care that can keep them safe from the different risk factors of recurrence. So, if you are going through ureteric strictures, make sure you check out MASSH. We are experts in treating all types of urinary conditions and offer specialised minimally invasive surgeries to treat all types of ureteric strictures. Our team of experts are highly qualified and trained to ensure you can keep away the risk of recurrent strictures. For more information, check out our website or visit us today.