What is Ureteral Stricture? Understand its causes and symptoms

Ureters are the slender tubes carrying urine from the kidneys to the urinary bladder, the storage organ of the body. Ureteral stricture is a disease in which there is narrowing in those tubes, disrupting the flow of urine from the kidneys. If left untreated, it leads to various complications.

1. What are the primary causes behind ureteral stricture development?

Any injury or infection involving parts of the ureter can cause scarring and subsequently narrowing. Common causes of ureteral strictures are urinary infections, especially tuberculosis, which is widely prevalent and endemic in India; post-surgery; cancers of the urinary tract; injury to the ureters after a road traffic accident; stab or gunshot injury; and post-radiotherapy.

2. What symptoms indicate the presence of ureteral stricture, and how can they be recognized?

The symptoms of ureteral stricture can vary depending on the severity and location of the narrowing. Common signs and symptoms include:

• Flank pain: dull, aching pain in the side or back
• Urinary tract infections (UTIs): recurring UTIs, accompanied by symptoms such as frequent urination, burning sensation during urination, and cloudy or foul-smelling urine.
• Occasionally, presence of blood in the urine or hematuria, may be one of its manifestations.

3. What are the potential risks associated with untreated ureteral strictures?

Many times, the symptoms of ureteral stricture are vague, non-specific and sometimes absent altogether. This leads to a delayed consultation with the urologist. Hence, such a long-term ureteral obstruction can lead to permanent kidney damage or renal failure if left untreated.

4. What measures can be taken to prevent ureteral strictures?
As delayed detection has the potential to cause permanent kidney damage, it’s important to promptly consult a urologist for any urinary or kidney related concerns or symptoms. Adequate treatment of UTIs and timely follow up consultations are essential steps to prevent complications.

5. What treatment options are available for managing them?
Treatment depends on the location, severity, as well as presenting symptoms or complications. Options include opening the narrow part using laser endomyotomy or dilatation, putting a stent in for simple strictures. For more complex or recurrent strictures, reconstructive urosurgery may need to be performed. With technological and skill advancements, these kinds of complex surgeries can be done in a minimally invasive keyhole manner, leading to better patient comfort as well as surgical outcomes.

Ureteral stricture is a manageable condition with prompt diagnosis and treatment. If you experience symptoms suggestive of ureteral stricture, don't hesitate to seek a urologic consultation to optimize the health and function of the kidneys and urinary tract.

(Article Courstesy: Dr. Tejas Mistry, Consultant Urologist, Andrologist & Kidney Transplant Surgeon, Bhailal Amin General Hospital, Vadodara)

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