Objectives: Proximity of ureters with iliac arteries makes them prone to damage by aorto-iliac pathology or surgery. The aim of this retrospective study is to analyse the incidence, the predisposing factors, and the optimal treatment of ureteral stenosis (US) or leakages (UL).
Design: Retrospective study.
Material: Fifty-one ureteral lesions in 41 patients referred to the urologist in a fourteen years period in the same institution.
Methods: Lesions are classified in three groups: A, preoperative; B, less than 3 months postoperatively; and C, more than 3 months postoperatively. Group A comprises 10 abdominal aortic aneurysm (AAA) patients; eight of the AAA are of the inflammatory type. Group B comprises 16 patients, 11 US and 9 UL. Group C comprises 15 patients and 15 US.
Results: Endoureteral treatment was successful in most of the group B patients. Some of them, however, had to be submitted to secondary open surgery, so that the global success rate is 70% in group B. In group C, the response is poor following endourological treatment alone (12.5% success) and open surgery is more often needed (3 ureterolyses and 1 nephrectomy). Global success rate is 40%.
Conclusion: Early diagnosis is associated to better results with less invasive procedure; late diagnosis is accompanied by a lower success rate of endourological treatment and requires more often primary open surgery.