Surgical treatment planning should consider the patient’s general condition and life expectancy in addition to the underlying cause.
1st order
- Perform endoscopic refluxoplasty (surgery to prevent reflux in the presence of ring muscle sphincter weakness). The success rate with this standardized method is about 95%.Antibiotic therapy in children with vesicoureteral reflux can halve the recurrence rate (recurrence) of urinary tract infections but cannot protect against renal scarring.
- Tumor-related ureteral obstruction (ureteral obstruction): permanent supply by means of DJ stent (implant to keep the ureter open; significant negative impact on quality of life); if necessary, segmental metal stents (change after about 12 months).
- Benign ureteral strictures (benign high-grade narrowing of the ureter) up to 2 cm in length:
- Endoscopic balloon dilatation ( dilatation of the stenosed ureter using a liquid- or air-fillable balloon catheter; success rates of approximately 52% after 16 months; method is now rarely used).
- Endoureterotomy (for chronic benign ureteral strictures; success rate of approximately 80% after 27 months).
- Prolonged strictures: various reconstructive measures (ureteroureterostomy; Politano-Leadbetter ureterocystoneostomy; transureteroureterostomy).
