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[Reconstructive surgery of ureteral stricture disease].


 Ureteral strictures with consecutive hydronephrosis may result from endourological or surgical intraperitoneal and intrapelvic procedures, intra- or extraluminal inflammatory processes, radiation therapy to adjacent organs, and spontaneous passage of ureteral calculi. Anatomical location, stricture length, age and comorbidities of the patient as well as previous surgeries in the peritoneal cavity and the retroperitoneum or pelvis minor have to be considered when planning surgical correction. Treatment options include various surgical techniques ranging from simple stricture excision and end-to-end anastomosis to ureterolysis with omental wrapping, ureteroneoimplantation, renal autotransplantation and ureter-ileum replacement. Besides surgical reconstruction, minimally-invasive procedures such as the placement of self-expandable thermostents or a pyelovesical bypass prosthesis must be integrated in the process of differential therapy. If the indication for surgery is adequate, all procedures have a long-term success rate of more than 90 % and a rate of significant complications < 5 %. This article aims to highlight the various therapeutic options and to give some recommendations on how to select individual treatment options.
