Surgical treatment of the stricture of the lower third of ureter after radiation therapy of pelvic organs

Postradiation obstructive changes of distal parts of the ureter most commonly occur after radiation therapy for cervical cancer, endometrial cancer, bladder cancer. Pathogenesis of postradiation lesions of the ureteral wall are explained by destructive effects of radiation on the basal membranes of the capillary cell, causing an occlusion, thrombosis, and neovascularization, which in turn leads to proliferation of fibroblasts and stromal fibrosis. Possible complications include hematuria, urinary tract infections, vesicoureteral reflux, stent migration, stent encrustation. By the way, presence of the stent is often associated with pain and discomfort in patients. Aim of this work is to improve the results of treatment of strictures of the lower ureter following radiotherapy, by evaluating effectiveness of extravesical uretherocystoanastomosis and Boari procedure. 

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