Abstract: PD42-03
Sources of Funding: none

Introduction

Stricture ureter due to bilharzias is characterized by focal destruction of ureteral muscle. With the advancements of endourologic techniques and increasing in experience made endouretrotomy the treatment of choice for surgical repair for most benign ureteral strictures._x000D_ There is debate about the optimal size of uretral stent size after endouretrotomy. However, many studies recommend larger caliber stents (12-14 Fr)._x000D_ We evaluate our initial experience of insertion of single uretral stent versus two stent after management of bilharzial uretral stricture by laser endouretrotomy._x000D_

Methods

Within 2.5 years, 54 patients under went retrograde laser endouretrotomy for bilharzial stricture ureter (diagnosed by positive history of bilhaziasis, positive serology test, bilhazial cystocopic finding, no history of stone, or urologic or pelvic surgery). Patients were randomized into two group, group I (27 patients) have two DJ (7 Fr each) while group II (27 patients) those have single DJ 7 Fr (after endouretrotomy). DJ was removed after 8 weeks. Follow-up was done regularly for 1 year by clinical interpretation and imaging studies. _x000D_ Patients' characters, operative data, operative results (subjectively and objectively) were compared in both groups._x000D_

Results

Fifty one complete follow-up >12 month, mean age 46.3 (16-70) Vs 45.2 (18-62) years, mean stricture length 1.48 (0.5-3) Vs 1.27 (0.5-2.5) cm, mean follow-up 20.6 (12-30)Vs 19.4 (12-30) month for group 1 and 2 respectively, (with no significant difference between both group). Success proved by relief of symptoms and radiographic resolution of obstruction. The success rate was significantly better in group (I) Vs group (II) (84% Vs 57.7%) p <0.039. _x000D_

Conclusions

Insertion of two DJ, post laser endoureterotomy for bilharzial stricture ureter associated with long term success rate then insertion of single DJ._x000D_

Funding

none