Distal Ureteral Strictures

Distal ureteral strictures can be defined as an abnormal narrowing involving the lower third of the ureter. Luminal obstruction can be partial or complete, with varying resultant effect. Most strictures pose clinical significance when they impair the ureter's principal function of expeditious forward transport of urine. Such an effect can result in pain, infection, calculus formation, or renal dysfunction. Strictures have historically been managed with open repair. However, advances in ureteroscope design, technique, and experience have reduced the morbidity and mortality associated with endoscopic repair. This chapter reviews the causes, diagnosis, and endoscopic management of distal ureteral strictures.