Ureteral stricture is a condition in which the narrowing of the ureter, the duct that carries urine from the kidney to the bladder, partially or completely blocks urine flow. Over time, this can cause urine to accumulate in the kidney, leading to the development of “hydronephrosis,” and if left untreated, it can progress to loss of kidney function.
Causes
Ureteral stricture can develop for various reasons:
- Previous urological surgeries
- Urinary tract stone disease and the damage it causes
- Recurrent or severe infections
- Trauma (external impact or surgical procedures)
- Congenital anatomical abnormalities
- Tissue damage after radiotherapy (in some patients)
Symptoms
Ureteral stricture can often progress insidiously, but in later stages the following complaints may appear:
- Pain in the flank and back area
- Recurrent urinary tract infections
- Fever and chills (if accompanied by infection)
- Deterioration in kidney function
- Decreased urine flow or signs of obstruction
Possible consequences
When left untreated:
- Enlargement of the kidney (hydronephrosis)
- Permanent kidney damage
- Loss of the kidney in advanced stages
- Recurrent infection attacks
Treatment options
The treatment plan is determined according to the location, length and severity of the stricture:
- Endoscopic dilation (balloon dilation)
- Opening the stricture with laser
- Placement of a stent (DJ catheter) inside the ureter
- Surgical reconstruction (ureteral repair or reconstruction)
- Open or robotic surgery in advanced and complex cases
In modern urology, many cases can be treated with closed and minimally invasive methods.
Frequently Asked Questions
Is ureteral stricture dangerous?
Yes. Because it blocks urine flow, it causes increased pressure in the kidney and can lead to loss of kidney function in the long term.
Does ureteral stricture heal on its own?
No. Since it is a structural narrowing, it usually does not resolve on its own and requires intervention.
Is treatment without surgery possible?
In some early or short-segment strictures, endoscopic dilation and stent placement may be sufficient. However, it is not suitable for every patient.
Why is a stent used?
A stent temporarily relieves urine flow and prevents damage to the kidney. It also supports the recovery process after treatment.
Does ureteral stricture recur?
Yes, there is a risk of recurrence, especially if the underlying cause persists. For this reason, regular follow-up is important.
Does ureteral stricture cause pain?
Yes. Flank pain can occur due to increased pressure in the kidney, especially when urine flow is blocked.
What happens if it is not treated?
Long-term obstruction can lead to permanent damage to kidney tissue, infections and even loss of the kidney.
Clinical Summary
Ureteral stricture is a disease that can be successfully treated with minimally invasive methods when detected early. However, since kidney function can be seriously affected in cases of late diagnosis, early urological evaluation is of great importance.
