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Endoscopic opening of pelvi-ureteric junction stricture.

Item number: 36825, 105

Endoscopic technique of incising a short stricture with a laser. A stent remains 6 weeks post operatively

Why is it done?

  • Stricturing or narrowing of the ureter causing significant hydronephrosis.
  • Leading to chronic infection.
  • End-result is loss of renal function.
  • An end to end anastomosis can be considered in the mid ureter.
  • A Reimplantaion into the bladder with lower ureteric strictures.
  • A pelvi-ureteric junction repair in higher ureteric strictures.
  • A trans uretero-ureteric anastomosis joining one ureter to the other where long defects are present.
  • Renal Auto Transplantation where ureter is completely damaged or.
  • An ileal ureteric substitution where to whole ureter is damaged.

How is it done?

  • Endoscopic technique.
  • Patients will receive a general anaesthesia.
  • Prophylactic antibiotics is given.
  • The correct ureteric system is identified and marked while you are awake.
  • This will be mostly a endoscopic procedure.
  • A Cystoscopy will be done with placement of ureteric guidewires./li>
  • The affected ureter is entered with ureteroscopy. Laser is used to cut through the short stricture until peri-ureteric fat is observed.
  • This is not an advisable procedure where the stricture overlies vascular structures.
  • A ureteric stent is placed.
  • An indwelling catheter is placed.

What next?

  • You may be in hospital for 3 days.
  • Your drain will be removed when there is no urine draining.
  • Your catheter will be removed the following day.
  • As soon as you are comfortable with no signs of pain and emptying your bladder sufficiently, you will be discharged.
  • A ward prescription may be issued on your discharge, for your own collection at any pharmacy.
  • A follow-up appointment will be scheduled for 6 weeks to remove your ureteric stent under local anaesthesia with a Flexible Cystoscope.
  • A review with a CT IVP will be scheduled 6 weeks after this to check on the end result of the ureter.
  • Any pain or signs of fever require an urgent review.
  • Don’t hesitate to ask Jo if you have any queries.

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Laser Endo-Pyelotomy