Ureteral Stricture

Narrowing of the ureter tube is called a ureteral stricture. Urine backs up into the kidney and causes side and back pain, sometimes kidney infections, kidney stones or  kidney damage to function of the kidney.

Woman with back pain
Cause

Cause of Ureteral stricture

Any injury to the ureter during surgery can cause surgical scarring.

Other causes by kidney stones, upper urinary tract inflammation, or a tumor. As scar tissue builds up in the ureter so does inflammation around the ureter.  This happens for many reasons including a

  • External traumatic injury or as a complication of a previous surgery
  • Procedure to manage kidney stones
  • Surgeries surrounding the ureters, for example, gynecologic or vascular surgical procedures
  • Radiation therapy for prostate cancer or other types of cancers
  • Tumors
  • Autoimmune
  • Congenital, meaning they are present at birth
Signs & Symptoms

Symptoms of Ureteral Stricture

  • Side or back pain
  • Feeling of fullness
  • Blood in the urine
  • Nausea
  • Urinary tract infections
  • Pain worse with increased fluids or alcohol
Tests

Tests for Ureteral Stricture

  • Renal ultrasound
  • CT scan
  • MRI scan
  • Renal Nuclear Medicine Scan
  • Retrograde Ureteroscopy (Surgeon looks up into the ureter with a small camera to see why there is scarring)

Ureteropelvic Junction Obstruction (UPJ)

The urine flow from the kidney into the the ureter is blocked.  The point of blockage is where the ureter (tube attached to kidney that drains urine to bladder) meets the collecting system or the portion of the kidney that collects the urine made by the kidney.

Doctor explains urology problems
Causes

Causes UPJ obstruction?

Most often this is congenital and happens from birth. But other causes include:

  • Abnormal blood vessel over the ureter
  • Scar tissue
  • Infection
  • Earlier treatments for a blockage
  • Kidney stones
Signs & Symptoms

Symptoms of UPJ obstruction?

The kidney can be damaged from the urine build up and this can cause:

  • Abdominal mass
  • Urinary tract infection
  • Back or flank pain
  • Bloody urine
  • Kidney infection
  • Vomiting
Diagnose

Diagnosing UPJ obstruction

  • CT urogram (scan of both kidneys with contrast)
  • Ultrasound
  • Urine and blood test
  • Nuclear scan of kidneys
  • X-ray of kidneys, bladder, ureters
  • Voiding cystourethrogram (X-ray of bladder while it is emptying)

Urinary Reconstruction and Diversion After Cystectomy

Often bladder cancer can require complete bladder removal, and for men, usually means the prostate as well.

For women this can mean removing the bladder plus the uterus, fallopian tubes, ovaries and top of the vaginal wall. When the bladder is removed, the surgeon must reconstruct the bladder so that the urine can pass from the kidney out of the body.  The kidneys which make the urine, the ureters which pass the urine to the bladder, and urethra which passes the urine out of the body are all still in place. There is no known artificial bladder has yet, the surgeon must create one one from intestine. Please See the Bladder cancer treatment page for more information.