With the technological advances in endourology, endoscopic treatments, including balloon dilation, cold knife incision, and laser endoureterotomy are also being used.
Of the eight patients treated with laser endoureterotomy, two required multiple endoscopic procedures, one had a subsequent nephrectomy, one had a subsequent ureteroureterostomy, and one had subsequent ureteral re-implant.
Also, endoureterotomy has been shown to be less successful in this cohort of patients and consideration for more definitive open surgical reconstruction is suggested from the onset of presentation.
One of the less invasive treatment options for ureteral strictures includes balloon dilation and endoureterotomy. With advancements in endourologic instrumentation, Ho:YAG laser endoureterotomy is a popular choice.
All eight patients undergoing endoureterotomy in our case series were treated with Ho:YAG laser.
She received two ureteral balloon dilatations and subsequent laser endoureterotomy. Unfortunately, she had ongoing severe flank pain and, despite periodic imaging and bloodwork showing stable hydronephrosis and renal function, her kidney atrophied one year post-laser endoureterotomy and she subsequently received laparoscopic nephrectomy.
Another patient with ureteral stricture from impacted stones failed laser endoureterotomy and went on to have an open segmental ureterectomy and ureteroureterostomy.
Finally, endoscopic management of benign ureteral strictures via balloon dilation and laser endoureterotomy is an excellent choice in properly selected patients, with opportunity for subsequent salvage treatments if needed.