Analysis on the Cause and Management of the Ureteral Obstruction

Ureteral obstruction is a common and important urologic disorder and may cause a hydronephrosis and result in the deterioration of renal function.

We made a clinical analysis on the cause and management of the 69 cases of the ureteral obstruction of the patients in the Department of Urology. Ewha Womans University Hospital during the period from January 1981 to December 1990.

The following results were obtained;

1) There were 36 cases(52.2%) of male and 33 cases(47.8%) of female and the major range of age distribution was between 30 decade to 50 decade, 45 cases(65.2%).

2) The level of obstruction was the upper ureter in 37 cases(51.4%), the mid in 2 cases(4.2%) and the lower in 32 cases(44.4%). The affected site was the right in 29 cases(40.3%), the left in 43 cases(59.7%) and the bilateral in 3 cases.

3) In etiology, 59 cases were caused by intrinsic factors, among which chronic inflammation of the ureter was the most common in 36 cases, and the extrinsic causative factors were found in 13 cases.

4) The degree of hydronephrosis was severe in 33 cases(45.8%), moderate in 22 cases(30.6%). mild in 6 cases(8.3%). and non-visualization of kidney in 11 cases (15.3%).

5) As the management of ureteral strictures. nephrectomy was done in 14 cases (19.4%). pyeloplasty in 11 cases(15.3%). ureteroneocystostomy in 5 cases (6.9%), segmental resection and end to end anastomosis in 8 cases(11.1%), ureteral dilation and stenting in 19 cases (26.4%) and percutaneous nephrostomy in 6 cases (8.3%).

6) The improvement of hydroncphrosis was observed in-85.7% on excretory urography, 6 months after treament.