How to manage ureteral stenosis associated with urinary calculi

The kidneys in the urinary system produce urine, which is collected through the tubes in the kidneys and then discharged through the ureters to the bladder for storage, and after reaching a certain amount, it is discharged out of the body through the urethra. Although the urinary ducts themselves have no function, abnormal ducts causing poor urine excretion may have a great impact on kidney function, and in serious cases may lead to loss of kidney function. Abnormalities in the urinary tract are mainly manifested as stricture or leakage, with stricture being the main cause. There are many causes of urinary tract stenosis, including: 1) congenital abnormalities, that is, developmental defects, narrowing of the tract at birth; 2) acquired diseases leading to stenosis, such as stones blocking the tract, tumors or inflammatory swelling of the tract can also lead to thinning of the lumen and affect urinary excretion, and ureteral stenosis is also common after chemotherapy for leukemia or bone marrow transplantation; 3) diseases outside the tract invading or 3, extraductal diseases invade or compress the ureter, such as radiotherapy for gynecological tumors, intestinal tumors, retroperitoneal tumors, etc.; 4, trauma, especially urethral injuries, long seen in falls from height or car accidents, etc.; 5, medically induced factors lead to damage to the narrowing of the ducts, because of the tenderness of the urinary ducts, the need for instruments to pass through the urinary ducts when doing intracavitary surgery, and sometimes the need to repeatedly enter and exit the urinary ducts, which may cause damage leading to narrowing of the ducts. In addition, when treating diseases in the ducts, such as stones or tumors, the ducts may also be damaged and narrowed. Therefore, minimally invasive surgery is not a minor surgery, let alone a non-invasive surgery, but it is a minimally invasive procedure that can have serious complications, despite the fact that it is less invasive than conventional surgery. With the increasing incidence of stones and the large number of stone-related surgeries, the incidence of stone-related ureteral strictures has increased significantly in recent years. Other diseases that commonly lead to ureteral stenosis include radiotherapy for gynecologic tumors, and ureteral stenosis after chemotherapy for leukemia and bone marrow transplantation is not uncommon. Ureteral stenosis often leads to hydronephrosis, which eventually affects kidney function in many patients and even results in the loss of kidney function and removal of the affected kidney. The correction of ureteral stenosis is similar to cosmetic surgery and is a restorative plastic surgery, which is more demanding and does require careful planning and design. Some patients may require lifelong placement of a stent or nephrostomy tube because the primary disease causing the ureteral stenosis cannot be removed. The persistence of the cause of ureteral stricture also leads to failure or difficulty in maintaining long-lasting results in many patients. Reconstruction of the urinary tract often requires replacement of the defective segment, but there is no perfect biomaterial that can replace the ureter. Therefore, complex ureteral strictures usually require comprehensive consideration to determine the treatment strategy and design the treatment plan.