Dilation and Stenting

This is one of the minimally invasive and earliest methods still in practice. It performed by inflating a balloon in the urethra or by inserting a catheter into the urethra. The objective is to stretch the ureteral stricture to a larger size. This is performed particularly in patients who have non-anastomotic strictures. The patient is given local anesthesia. The stricture is stretched using large dilators called sounds. Also a special balloon or a catheter can also be used to dilate the ureter. This is not a permanent cure as the underlying scar tissue remains untreated which causes the stricture to recur again. Hence the treatment has to be treated periodically. This is used as a short term procedure in patients till a better cure is obtained. In case of rapid recurrence of strictures, the patient is taught how to perform self dilation at home to keep prevent closure of the ureter.

Sometimes a ureteral stent will have to be used to ensure passage of urine from the kidneys to the bladder smoothly. Mostly an open ended stent is used for purpose of temporary drainage. The stent material is flexible, durable, and non reactive substance. The stent has a thread attached which makes its removal easy. The patient is kept under general anesthesia. A cystoscope inserted into the urethra to the bladder, so as to identify opening to the ureter to be stented. A guide wire is inserted into the ureter with the e help of a fluoroscope. A pathway for the placement of the stent is created, which is advanced over the wire. After placing the stent, accurately the guide wire and cystoscope are removed. The main problems after dilation are pain, bleeding, and infection.