URETERAL STRICTURES: PREVALENCE, ETIOLOGY, METHODS OF SURGICAL TREATMENT (RESULTS OF A RETROSPECTIVE STUDY)

Background. In recent years, the number of ureteral strictures, which are narrowings of the ureter causing functional obstruction, has been progressively increasing. First of all, this is due to the increasing number of minimally invasive endoscopic and laparoscopic surgeries, as well as treatment of cancers of various localizations using radiation therapy. The purpose of the study is to analyze the prevalence, etiology of ureteral strictures and methods of their surgical treatment. Material and methods. The objects of the retrospective study were 639 patients with ureteral strictures, who were treated in the urological departments of the Minsk Regional Clinical Hospital from 2008 to 2024. Results. In the group of patients with ureteral strictures, young and middle-aged patients prevailed – 59% and 23%, respectively; the elderly accounted for 14% of cases, the senile – 1%. Among the patients, males (n = 460) predominated and 179 cases were recorded among females, which amounted to 72% and 28%, respectively. Over the study period, the incidence rate increased by 12.9 times. The prevalence of ureteral strictures in 2024 was 7.3 cases per 100,000 residents of the Minsk region. In 2008, this figure was 0.6 cases per 100 thousand population. Distal strictures (65%) prevailed, while the mid and proximal strictures rarely occurred (10% and 18%, respectively), strictures of the ureteropelvic junction were observed in 7% of cases. Endourological operations for urolithiasis (36%), tumor invasion or compression in oncological diseases (21%), gynecological operations (14%), urological operations (excluding those in urolithiasis) (13%), radiation therapy (10%) were the main causes of ureteral strictures. In isolated cases, other causes of ureteral strictures were recorded, such as proctological operations and other diseases. In most cases, 58% of patients underwent ureteroscopy with JJ-stenting of the ureter, in 25% of cases open ureteroneocystoanastomosis was performed, open end-to-end ureteroplasty was used in 5% of patients, other types of plastic surgery were performed in 4% of cases, laparoscopic operations (ureteroneocystoanastomosis, end-to-end ureteroplasty) were used in 2% of patients. Conclusion. The results obtained by us in a retrospective study are consistent with modern literature data and confirm the high medical and social significance of the studied pathology, which requires the development of new minimally invasive methods of medical prevention and surgical treatment of ureteral strictures.