Strictures are narrowings of the ureter associated with abnormal, unhealthy tissue. Strictures may form in the ureter from the passage of stones, previous surgery, radiation therapy for cancer or for reasons not yet completely understood. However, when a stricture does form and is associated with obstruction of the kidney it must be corrected. Ureteroscopy allows the surgeon to locate the stricture and repair the stricture using balloon expansion, electrical incisions or lasers. It is a minimally invasive technique and prevents a skin incision.

Cancer, which forms from the lining of the urinary system, is known as transitional cell carcinoma and may arise anywhere along this tract. (Picture ) When transitional cell carcinoma occurs within the kidney or ureter it is a particularly difficult problem. It may be difficult to make the diagnosis since it may be mistaken for a stone, a blood clot or a non-cancerous lesion. When the diagnosis is made the treatment often involves removing the kidney and ureter on the side where the tumor is present (nephroureterectomy). Ureteroscopy has allowed the minimally invasive urologist to more accurately diagnose this disease and in certain situations treat the cancer through the ureteroscope.

Regarding stone disease ureteroscopy is excellent. Up to 95% of patients who undergo ureteroscopy for stones are made stone free. Very few complications have been noted in this group of patients with the majority of patients returning home the day of or 24 hours after the procedure.

To treat strictures of the ureter the success of ureteroscopy is dependent on the length of the stricture, and the cause of the stricture. In favorable circumstances the success rate is 80% in less then favorable circumstances the success rate approaches 50%. In either case it is a minimally invasive procedure which does not require an incision and has little down side in experienced hands.