Bilharzial Strictures of the Lower Third of the Ureter: a Critical Review of 560 Strictures

Abstract

In a series of 329 patients with urinary bilharziasis, 560 strictures occurred in the lower 1/3 of the ureter. Bilateral ureteric involvement was seen in 231 patients (70.2%). Strictures (252; 45%) were juxtavesical, 210 (37.5%) intramural, 50 (8.9%) combined juxtavesical and intramural, 43 (7.7%) pelvic and 5 (0.9%) ureteric meatal. The main operative procedures were pull-through ureteroneocystostomy (47.1%), ureteric reimplantation into the bladder dome (28.8%) and nipple ureteroneocystostomy (20.3%). Post-operative complications occurred in 17 patients (5.2%) and the operative mortality was nil. The best results are achieved through selection of appropriate operative procedure and prevention of reinfestation.