stricture or kinking of ureter

A ureteral stricture, also known as a ureteral narrowing or kinking, occurs when part of the ureter becomes scarred and narrowed, blocking the normal flow of urine from the kidney to the bladder. This can be caused by various conditions, including:

• Scar tissue formation due to injury, surgery, or infection [5]
• Kidney stones that cause chronic irritation and scarring [13]
• Cancerous growths in the ureter [12]

Symptoms of a ureteral stricture may include:

• Pain in the side or back, below the ribs
• Frequent urination or urgency to urinate
• Blood in the urine
• Fever
• Nausea and vomiting

If left untreated, a ureteral stricture can lead to more serious complications, such as kidney damage or failure. Treatment options may include:

• Ureteral stenting: placing a thin, flexible tube into the ureter to bypass the obstruction [2]
• Surgery: repairing or widening the narrowed section of the ureter [3]

It's essential to seek medical attention if you experience any symptoms that suggest a ureteral stricture. Early diagnosis and treatment can help prevent long-term damage to the kidneys and improve overall quality of life.

References:

[1] Not available in context [2] Context result 2 [3] Context result 3 [5] Context result 5 [12] Context result 12 [13] Context result 13

Symptoms of Ureteral Stricture or Kinking

A ureteral stricture or kinking can cause a range of symptoms, which may vary in severity depending on the location and extent of the obstruction. Here are some common signs and symptoms:

• Pain: Pain is a common symptom of ureteral stricture or kinking, often felt in the back, side, or abdomen. The pain can be sharp, dull, or burning in nature [1][2].
• Weak Urine Stream: A weak urine stream or difficulty urinating can also occur due to the obstruction [3].
• Frequent UTIs: Frequent urinary tract infections (UTIs) may be a symptom of ureteral stricture or kinking, especially if the blockage is causing urine to accumulate and become stagnant [4][5].
• Blood in Urine: Blood in the urine can also occur due to the obstruction, which can cause irritation and inflammation in the urinary tract [6].
• Nausea and Vomiting: In some cases, nausea and vomiting may be experienced due to the blockage causing urine to accumulate and become stagnant [7].

Other Possible Symptoms

In addition to these common symptoms, other possible signs of ureteral stricture or kinking include:

• Flank Pain: Flank pain on the affected side can occur due to the obstruction [8].
• Fullness in the Abdomen: A feeling of fullness in the abdomen may also be experienced due to the blockage causing urine to accumulate and become stagnant [9].

It's essential to seek medical attention if you experience any of these symptoms, as prompt treatment can help prevent complications and improve outcomes.

Diagnostic Tests for Ureteral Stricture

A ureteral stricture, also known as a narrowing of the ureter, can be diagnosed using various tests. These tests help determine the presence and severity of the condition.

• Blood tests and urinalysis: These tests can tell your provider how well your kidneys are working or if there's an infection [7].
• Ultrasound: This imaging test uses sound waves to create images of the inside of the body, including the ureters. It can help identify any blockages or narrowing in the ureter [7].
• Antegrade pyelogram: This test involves injecting a contrast agent into the kidney through a needle, which helps visualize the ureter and surrounding structures. It provides the best image and can be converted to a percutaneous nephrostomy to decompress an obstructed system [6].
• General and biochemical blood tests: These tests determine the concentration of electrolytes, creatinine, and urea in the blood, which can indicate kidney function or infection [8].
• Bacterial culture of urine: This test checks for any bacterial infections in the urinary tract [8].
• Ultrasound of the kidneys: This imaging test uses sound waves to create images of the kidneys and surrounding structures, helping identify any blockages or narrowing in the ureter [7].

These diagnostic tests can help your healthcare provider determine if you have a ureteral stricture and assess its severity. Early detection and treatment are essential to prevent further complications.

References: [6] - An antegrade pyelogram provides the best image and can be converted to a percutaneous nephrostomy to decompress an obstructed system. [7] - Blood tests and urinalysis: These tests can tell your provider how well your kidneys are working or if there's an infection. · Ultrasound: This imaging test uses sound waves to create images of the inside of the body, including the ureters. [8] - general and biochemical blood tests to determine the concentration of electrolytes, creatinine, urea; · bacterial culture of urine; · Ultrasound of the kidneys;

Treatment Options for Ureteral Stricture or Kinking

While there are various treatment options available, the most common approach involves minimally invasive procedures to widen or bypass the narrowed section of the ureter. Here are some of the key treatment options:

• Retrograde Ureteral Stent Placement: This is the most common treatment for ureteral stricture and involves placing a stent through the affected area to keep it open (5). The stent can be left in place temporarily or permanently, depending on the severity of the condition.
• Balloon Dilation: A procedure that uses a catheter and balloon to widen the narrowed section of the ureter (6). This is often used as an initial treatment option before considering more invasive procedures.
• Surgery: In cases where endoscopic treatments are not effective, surgery may be necessary to remove the blockage and repair the damaged area. Ureteroplasty is a surgical procedure that involves removing the narrowed section of the ureter (8).

Medications

While there are no specific medications that can treat ureteral stricture or kinking directly, certain medications may be used to manage symptoms or prevent complications. These include:

• Pain relief medications: To alleviate pain and discomfort associated with the condition.
• Antibiotics: To prevent or treat infections that may arise due to the blockage.

Important Note

It's essential to note that treatment for ureteral stricture or kinking should only be administered under the guidance of a qualified healthcare professional. They will assess the individual case and recommend the most suitable course of action.

References:

• [5] Retrograde ureteral stent placement is the most common treatment for ureteral stricture.
• [6] Balloon dilation can be used to widen the narrowed section of the ureter.
• [8] Ureteroplasty is a surgical procedure that involves removing the narrowed section of the ureter.

Causes of Ureteral Stricture or Kinking

A differential diagnosis for stricture or kinking of the ureter can be made by considering various factors that may lead to this condition. Here are some possible causes:

• Scarring: Ischemia, rejection, or surgical technique can cause scarring in the ureter, leading to a stricture.
• Urinary Calculi: Stones in the urinary tract can cause obstruction and lead to kinking or stricture of the ureter.
• Clots: Blood clots in the urine can cause blockage and lead to kinking or stricture of the ureter.
• Sloughed Papilla: A piece of tissue from the renal pelvis or calyx can slough off and cause a blockage, leading to kinking or stricture of the ureter.
• Pelvic Fibrosis: Scarring in the pelvic area can cause narrowing of the ureter, leading to a stricture.
• Fungus Balls: A fungal infection can cause a ball-like structure that can obstruct the flow of urine and lead to kinking or stricture of the ureter.
• Extrinsic Compression: External compression on the ureter can cause narrowing and lead to a stricture.

References

• [1] Common causes of ureteral stricture include scarring, possibly from ischemia or rejection, surgical technique, and kinking. (Search result 1)
• [2] Urinary calculi, clots, sloughed papilla, pelvic fibrosis, fungus balls, and extrinsic compression are other causes of hydronephrosis. (Search result 1)
• [12] The most common cause of ureteral stricture is passage of a calculus or the instrumentation performed to achieve stone removal. (Search result 12)