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If you’re experiencing flank pain, recurrent urinary tract infections, or kidney problems, it may be due to a ureteral stricture — a narrowing of the ureter, the tube that carries urine from the kidney to the bladder. Often caused by scar tissue, injury, or prior surgery, this condition can block the normal flow of urine, making it essential to understand its causes, recognize the symptoms, and know when to seek medical attention.
How Does a Ureteral Stricture Happen?
The conditions are caused by a gradual buildup of scar tissue in the ureters, the two tubes that carry urine from the kidneys to the bladder. It’s generally more common in men over age 55. Women can develop the condition, but it’s extremely rare and difficult to diagnose. In men, the condition occurs in about 229-627 of every 100,000 males. The scar tissue can develop because of:
- Congenital obstructions
- Injury to your penis or scrotum
- Infection, usually caused by a sexually transmitted disease, such as chlamydia.
- Kidney stones
- Urethral or prostate cancer
- Placing urinary catheters or surgical instruments in the urethra during a medical procedure
- Radiation therapy
- Retroperitoneal fibrosis (scar tissue forming in the retroperitoneum behind the abdominal lining and obstructing the urethra)
Symptoms of a Ureteral Stricture
The reasons for a ureteral stricture can occur long before you notice any of the common symptoms. The symptoms include:
- Urinary tract infections (UTIs)
- Blood in the urine
- Flank or side pain (often intermittent or colicky)
- Lower back pain
- Hydronephrosis (swelling of the kidney due to urine backup, seen on imaging)
A severe ureteral stricture may prevent you from urinating at all. This condition is called acute urinary retention and requires immediate treatment. Urine can back up in your urinary system and cause one or both of your kidneys to swell or fail.
Early symptom recognition opens up more treatment choices and often leads to improved results.
Diagnosing Ureteral Strictures
If you find yourself straining to urinate or suffering any of the other common symptoms, contact the urology department at Vejthani International Hospital. Doctors can administer a series of tests to find issues that may prevent you from emptying your bladder. The tests may include:
- CT scans
- Ultrasound
- MRI scans
- Renal Scans (this test determines the level of kidney function and the extent of ureter obstruction)
- Retrograde Ureteroscopy (this test uses X-rays and contrast dye injected into the ureter to find the blockage)
Treating Ureteral Strictures
All ureteral stricture treatments aim to widen the ureter to allow urine to flow freely. There are minimally invasive treatments and surgical treatments for severe strictures. They include:
Minimally Invasive Treatments
- A Balloon Dilation inserts a tiny balloon into the ureter and inflates it to widen the vessel and improve urine flow.
- An endoscopic incision (Endoureterotomy) is a procedure that makes a small incision with a laser or scalpel at the stricture. Instruments passed through a ureteroscope are then used to expand the ureter.
- Stenting is a procedure in which a thin tube (stent) is placed in the ureter to hold it open either temporarily or as a long-term solution.
- In a percutaneous nephrostomy, an external, temporary tube is placed into the kidney to drain the urine. This bypasses the stricture to provide immediate relief.
Surgical Treatments (Ureteral Reconstruction)
- A ureteroureterostomy is a procedure that removes the part of the ureter containing the stricture. The healthy ends are then surgically reconnected.
- A ureteroneocystostomy involves detaching the ureter and reattaching it in a new location on the bladder to create a protected tunnel that prevents urine from flowing backwards (reflux).
- In some cases, tissue grafting procedures using oral mucosa or a section of bowel can replace the ureter segment containing the stricture.
The treatment choices depend on the causes and severity of the strictures.
When to Seek Medical Help
If you experience any of the following symptoms, you should head to the nearest emergency room for immediate treatment:
- Increasing pain while urinating
- Blood in your urine
- Inability to urinate
- Signs of an infection or high fever (chills and shaking)
How to Prevent Ureteral Stricture
Some tips to help avoid the common causes of a ureteral stricture include:
- Stay hydrated
- Practice good hygiene to prevent infections
- Wear athletic supporters and cups when playing aggressive sports
- Be cautious with activities that could damage the abdomen or lower back
Visit Vejthani International Hospital for Treatment of Ureteral Strictures
If you’re experiencing any common symptoms or have concerns about your urinary health, consult a doctor at Vejthani International Hospital before the issue becomes a severe problem.
For more information, please contact
Urology and Men’s Health Center, Vejthani Hospital.
Call: (+66)2-734-0000 ext. 4901
English Hotline: (+66)85-223-8888
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