Ureteral Strictures Following Ureteroscopic Ureteral Wall Injury: A Previously Unidentified Concern “Presentation”

May 5, 2024

Andrei Cumpanas presented a study on ureteral strictures following ureteroscopic ureteral wall injury, highlighting a previously unidentified concern. The study aimed to determine the risk of post-ureteroscopic ureteral stricture formation based on the depth of injury into the ureteral wall, revealing that stricture rates increase significantly when the ureteral wall is partially or fully transgressed.

Biography:

Andrei D. Cumpanas, MD, Researcher, Department of Urology, The University of California, Irvine, CA

 

Read the Full Video Transcript

Andrei D. Cumpanas: Dear viewers. My name is Andrei Cumpanas. I'm a LIFT research scholar here in the University of California Irvine Department of Urology. And today I'll be presenting the results of our study, Ureteral Strictures Following Ureteroscopic Ureteral Wall Injury: A Previously Unidentified Concern.

We sought to determine the risk of post-ureteroscopic ureteral stricture formation based on the depth of injury into the ureteral wall.
550 patients who underwent flexible ureteroscopy for upper tract urinary calculi between 2018 and 2022 were included.
The Post-Ureteroscopic Lesion Scale, or the PULS score, was used to assess the ureteral integrity at the end of each flexible ureteroscopy.

Ureteral stricture formation was defined on follow-up imaging three to six months after surgery, either by CT, ultrasound, nuclear medicine renal scan, or subsequent endoscopy on the ipsilateral side.

De-novo stricture rates rose sharply when ureteral wall architecture was disrupted, from 0% for PULS 0s, to 1.1% for PULS 2 ureteral abrasions, to 13% for PULS 3 transmural injuries.

In the presence of urothelial abrasions or transmural ureteral injuries, the odds of a stricture rose by 13 to 40 times respectively.
In conclusion, stricture rates surge when the ureteral wall is partially or fully transgressed. A two-tier grading system based on ureteral wall integrity defines the risk of stricture formation.

Thank you.