{"id":6059,"date":"2023-02-08T09:09:29","date_gmt":"2023-02-08T02:09:29","guid":{"rendered":"https:\/\/drsoaraweeurology.com\/?p=6059"},"modified":"2026-08-25T20:29:00","modified_gmt":"2026-08-25T13:29:00","slug":"ureteral-stricture-%e1%80%96%e1%80%bc%e1%80%85%e1%80%ba%e1%80%85%e1%80%b1%e1%80%90%e1%80%9a%e1%80%ba%e1%81%8b","status":"publish","type":"post","link":"https:\/\/drsoaraweeurology.com\/my\/2023\/02\/08\/ureteral-stricture-causing\/","title":{"rendered":"\u1006\u102e\u1038\u101c\u1019\u103a\u1038\u1000\u103c\u1031\u102c\u1004\u103a\u1038\u1000\u103b\u1009\u103a\u1038\u1001\u103c\u1004\u103a\u1038- \u1000\u103b\u1009\u103a\u1038\u1019\u103c\u1031\u102c\u1004\u103a\u1038\u1014\u1031\u101e\u1031\u102c \u1006\u102e\u1038\u101c\u1019\u103a\u1038\u1000\u103c\u1031\u102c\u1004\u103a\u1038\u1000 \u1000\u103b\u1031\u102c\u1000\u103a\u1000\u1015\u103a\u1000\u102d\u102f \u1021\u101e\u1036\u1010\u102d\u1010\u103a \u1019\u100a\u103a\u101e\u102d\u102f\u1037 \u1016\u103b\u1000\u103a\u1006\u102e\u1038\u1014\u102d\u102f\u1004\u103a\u101e\u1014\u100a\u103a\u1038"},"content":{"rendered":"\n<div class=\"wp-block-columns coblocks-author-columns has-background is-layout-flex wp-container-core-columns-is-layout-52275889 wp-block-columns-is-layout-flex\" style=\"background-color:#8C8C971A;padding-top:2.5rem;padding-right:2.5rem;padding-bottom:2.5rem;padding-left:2.5rem\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:25%\">\n<figure class=\"wp-block-image size-full is-style-rounded\"><img data-recalc-dims=\"1\" fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"800\" data-attachment-id=\"7037\" data-permalink=\"https:\/\/drsoaraweeurology.com\/my\/new-photo-2024\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" data-orig-size=\"800,800\" data-comments-opened=\"1\" 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1.246.262.353.175.622.443.806.804.044.083.083.157.117.222.034.066.069.144.105.235.022.054.011.099-.034.135l-.66.292c-.045.027-.082.013-.112-.045a4.043 4.043 0 0 0-.155-.27 1.247 1.247 0 0 0-.49-.495c-.225-.131-.522-.196-.892-.196-.402 0-.726.064-.972.193-.247.13-.422.302-.527.518-.027.045-.054.099-.082.16a1.39 1.39 0 0 0-.067.197 2.46 2.46 0 0 0-.05.282 5.51 5.51 0 0 0-.033.43c-.008.17-.013.376-.013.617 0 .242.005.448.013.618.008.17.02.314.034.43.013.117.03.21.05.282.02.072.042.137.066.197.105.216.28.39.527.518.246.13.57.193.972.193.4 0 .714-.07.94-.21.227-.14.394-.346.503-.617a2.43 2.43 0 0 0 .104-.395c.018-.123.027-.282.027-.477V13.2H2.34c-.04 0-.06-.02-.06-.062v-.5c0-.04.02-.062.06-.062h1.812c.04 0 .062.02.062.06v.5c0 .156-.005.296-.014.422a4.71 4.71 0 0 1-.04.342 1.732 1.732 0 0 1-.064.262c-.13.523-.402.913-.815 1.17-.413.255-.95.382-1.61.382z\"\/>\n    <\/svg>\n  <\/a>\n  \n  <a href=\"https:\/\/orcid.org\/0009-0004-8387-3559\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"ORCID iD\"\n     aria-label=\"View ORCID Profile\"\n     style=\"text-decoration: none; color: #A6CE39; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M12 0C5.372 0 0 5.372 0 12s5.372 12 12 12 12-5.372 12-12S18.628 0 12 0zM7.369 4.378c.525 0 .947.431.947.947 0 .525-.422.947-.947.947-.525 0-.946-.422-.946-.947 0-.525.421-.947.946-.947zm-.722 3.038h1.444v10.041H6.647V7.416zm3.562 0h3.9c3.712 0 5.344 2.653 5.344 5.025 0 2.578-2.016 5.025-5.325 5.025h-3.919V7.416zm1.444 1.303v7.444h2.297c3.272 0 4.022-2.484 4.022-3.722 0-2.016-1.284-3.722-4.097-3.722h-2.222z\"\/>\n    <\/svg>\n  <\/a>\n  \n  <a href=\"https:\/\/scholar.google.com\/citations?user=lTgsRMUAAAAJ&#038;hl=en\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"Google Scholar\"\n     aria-label=\"View Google Scholar Profile\"\n     style=\"text-decoration: none; color: #4285F4; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M5.242 13.769L0.5 9.5 12 1l11.5 8.5-4.742 4.269C17.548 11.249 14.978 9.5 12 9.5c-2.977 0-5.548 1.748-6.758 4.269zM12 10a7 7 0 1 0 0 14 7 7 0 0 0 0-14z\"\/>\n    <\/svg>\n  <\/a>\n  \n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">The ureter is the narrow tube carrying urine from a kidney down to the bladder \u2014 about the width of a drinking straw. A <strong>ureteral stricture<\/strong> is a scarred segment that has narrowed it. Urine backs up, the kidney above swells, and over time that kidney can be damaged.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This is not the same as a <a href=\"https:\/\/drsoaraweeurology.com\/2021\/05\/14\/urethral-stricture-narrow-urethra\/\">urethral stricture<\/a>, which affects the tube from the bladder to the outside and causes a weak stream. The names are confusingly similar and the conditions are entirely different. This page is about the ureter.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Urology center Bangkok hospital Thailand\u00a0<a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\" target=\"_blank\" rel=\"noreferrer noopener\">Booking online<\/a>\u00a0<a href=\"tel:02-310-3009\">02-310-3009<\/a>\u00a0<a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a><\/li>\n\n\n\n<li>Samitivej Sriracha hospital Chonburi&nbsp;<a href=\"tel:088-022-1445\">088-022-1445<\/a><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">The reason this condition is dangerous<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">This was missing from the earlier version of this article and is the most important thing on the page.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A ureteral stricture frequently causes no symptoms at all.<\/strong> You have two kidneys. When one is gradually obstructed, the other compensates so completely that blood tests stay normal and nothing feels wrong. There is no pain, because the obstruction developed slowly rather than suddenly \u2014 unlike a stone, which announces itself violently.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Meanwhile the pressure inside the obstructed kidney destroys it quietly, over months. By the time anything is noticed, function on that side may be substantially or entirely gone, and lost kidney function does not come back.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">That is the entire argument for a piece of advice worth taking seriously: <strong>if you have had ureteroscopy for a stone, pelvic or abdominal surgery, or radiotherapy to the pelvis, attend the follow-up scan even though you feel completely well.<\/strong> Feeling well is not evidence that the kidney is well.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Symptoms, when there are any<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>A dull ache in the flank or side, sometimes worse after drinking a lot.<\/li>\n\n\n\n<li>Repeated urinary infections, or infections that keep returning on the same side.<\/li>\n\n\n\n<li>Blood in the urine.<\/li>\n\n\n\n<li>A rise in kidney blood tests \u2014 though usually only when both sides are affected, or when there is only one working kidney.<\/li>\n\n\n\n<li>Very often, nothing whatsoever, with the narrowing found on a scan done for another reason.<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"800\" data-attachment-id=\"6068\" data-permalink=\"https:\/\/drsoaraweeurology.com\/my\/2023\/02\/08\/ureteral-stricture-causing\/informative-illustration-of-kidney-stones-2\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Kidney-stone.jpg?fit=1200%2C1200&amp;ssl=1\" data-orig-size=\"1200,1200\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;Informative illustration of kidney stones illustration&quot;,&quot;created_timestamp&quot;:&quot;1595695827&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;Informative illustration of kidney stones&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Ureteral stricture: Causing and Treatment\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;History of kidney stone or ureteral stone is an essential history&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Kidney-stone.jpg?fit=800%2C800&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Kidney-stone.jpg?resize=800%2C800&#038;ssl=1\" alt=\"Kidney stone, a common cause of ureteral stricture both from the stone itself and from the surgery to remove it\" class=\"wp-image-6068\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Kidney-stone.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Kidney-stone.jpg?resize=300%2C300&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Kidney-stone.jpg?resize=1024%2C1024&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Kidney-stone.jpg?resize=150%2C150&amp;ssl=1 150w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Kidney-stone.jpg?resize=768%2C768&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Kidney-stone.jpg?resize=12%2C12&amp;ssl=1 12w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Kidney-stone.jpg?resize=800%2C800&amp;ssl=1 800w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Kidney-stone.jpg?resize=400%2C400&amp;ssl=1 400w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Kidney-stone.jpg?resize=200%2C200&amp;ssl=1 200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Kidney-stone.jpg?resize=350%2C350&amp;ssl=1 350w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Kidney-stone.jpg?resize=750%2C750&amp;ssl=1 750w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Kidney-stone.jpg?resize=100%2C100&amp;ssl=1 100w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Stones cause strictures in two ways \u2014 by sitting impacted against the wall, and through the treatment used to remove them.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">What causes it<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Stones<\/strong> \u2014 both a stone impacted against the ureteric wall for a long period, and the instruments used to treat it. This is among the commonest causes.<\/li>\n\n\n\n<li><strong>Surgery near the ureter<\/strong> \u2014 gynaecological, colorectal or vascular. The ureter runs close to a great deal, and it can be injured directly or lose its blood supply from dissection nearby, with the narrowing appearing weeks or months later.<\/li>\n\n\n<li><strong>Radiotherapy<\/strong> to the pelvis, sometimes many years afterwards.<\/li>\n\n\n\n<li><strong>Cancer<\/strong> \u2014 of the urinary tract itself, or a tumour outside it pressing on or invading the ureter, cervical and colorectal cancers among them. Establishing whether cancer is involved is one of the first priorities.<\/li>\n\n\n\n<li><strong>Fibrosis around the ureter<\/strong> \u2014 from endometriosis, from an aortic aneurysm, or from retroperitoneal fibrosis, which can trap both ureters at once.<\/li>\n\n\n\n<li><strong>Tuberculosis<\/strong>, which scars the urinary tract and remains relevant in this region. It is also a cause of <a href=\"https:\/\/drsoaraweeurology.com\/2022\/07\/07\/sterile-pyuria-general-ideas\/\">white cells in the urine with a negative culture<\/a>, and finding it requires asking the laboratory for it specifically.<\/li>\n\n\n\n<li><strong>No identifiable cause<\/strong>, in a proportion of cases.<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"316\" data-attachment-id=\"6066\" data-permalink=\"https:\/\/drsoaraweeurology.com\/my\/2023\/02\/08\/ureteral-stricture-causing\/hands-showing-cancer-balloons-word\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Cancer.jpg?fit=1200%2C474&amp;ssl=1\" data-orig-size=\"1200,474\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;Hands showing cancer balloons word&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;Rawpixel Ltd.&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;Hands showing cancer balloons word&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Ureteral stricture: Causing and Treatment\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;The first thing we must find out is, any history of intra-abdominal cancer or not?&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Cancer.jpg?fit=800%2C316&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Cancer.jpg?resize=800%2C316&#038;ssl=1\" alt=\"Consultation about abdominal cancer history, an important cause of ureteral obstruction\" class=\"wp-image-6066\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Cancer.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Cancer.jpg?resize=300%2C119&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Cancer.jpg?resize=1024%2C404&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Cancer.jpg?resize=768%2C303&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Cancer.jpg?resize=18%2C7&amp;ssl=1 18w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Cancer.jpg?resize=750%2C296&amp;ssl=1 750w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Any history of cancer in the abdomen or pelvis changes the assessment entirely.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">The two questions that decide everything<\/h2>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Is there cancer behind this?<\/strong> A narrowing caused by a tumour is a different problem requiring different treatment, and it must be excluded rather than assumed absent.<\/li>\n\n\n\n<li><strong>Is this kidney worth saving?<\/strong> If it still works, the aim is to relieve the obstruction and preserve it. If it has already been destroyed, reconstructing the ureter achieves nothing, and the question becomes whether the dead kidney needs removing at all \u2014 often it does not, unless it is causing infection, pain or high blood pressure.<\/li>\n<\/ol>\n\n\n\n<h2 class=\"wp-block-heading\">The tests that answer them<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Ultrasound<\/strong> \u2014 shows whether the kidney is swollen, and is usually where the problem is first spotted.<\/li>\n\n\n\n<li><strong>CT urogram<\/strong> \u2014 shows where the narrowing is, how long it is, and what is around it, including a tumour.<\/li>\n\n\n\n<li><strong>A renal function scan<\/strong>, sometimes called a renogram or MAG3 scan. <strong>This is the test that matters most and the one patients most often have not had.<\/strong> It measures how much of your total kidney function each kidney is contributing, and whether urine is genuinely obstructed or merely draining slowly through a wide but floppy system. A swollen kidney on ultrasound does not by itself prove obstruction; this scan is what settles it, and its result decides between reconstruction, observation and removal.<\/li>\n\n\n\n<li><strong>Ureteroscopy with biopsy or urine cytology<\/strong>, where a tumour within the ureter is a possibility.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Treatment<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The earlier version of this article described ureteral stricture as generally a lifelong problem. <strong>That is unduly pessimistic and has been corrected<\/strong> \u2014 a well-selected reconstruction cures the narrowing definitively in a great many people. What is true is that some strictures, particularly long ones, those caused by radiation, and those in people whose general health limits major surgery, are managed rather than cured.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Observation<\/strong>, where the kidney contributes little, nothing is causing symptoms, and surgery would risk more than it gains. This is a legitimate decision, not a failure to treat \u2014 but it is made on the scan result, not on how well someone feels.<\/li>\n\n\n\n<li><strong>A ureteric stent<\/strong> \u2014 an internal tube keeping the ureter open. Effective and quick, and the usual first step in an emergency, but it needs changing every few months and many people find it uncomfortable. It is a holding measure more often than a destination.<\/li>\n\n\n\n<li><strong>A nephrostomy<\/strong> \u2014 a tube through the skin into the kidney, used when a stent cannot be passed or when drainage is urgent.<\/li>\n\n\n\n<li><strong>Endoscopic dilatation or incision<\/strong> \u2014 attractive because it is minor, but honest expectations matter: results are best for short, recently formed strictures where the blood supply is intact, and considerably less reliable for long or ischaemic ones. Recurrence is common.<\/li>\n\n\n\n<li><strong>Surgical reconstruction<\/strong> \u2014 cutting out the narrowed segment and rejoining the ureter, reimplanting it into the bladder, bringing the bladder up to meet it, or patching the ureter with a graft. Increasingly done robotically, which reduces the size of the incision without reducing what can be achieved inside. This is the definitive answer for most strictures in a kidney worth saving.<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"534\" data-attachment-id=\"6067\" data-permalink=\"https:\/\/drsoaraweeurology.com\/my\/2023\/02\/08\/ureteral-stricture-causing\/doctor-talking\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Doctor-talking.jpg?fit=1200%2C801&amp;ssl=1\" data-orig-size=\"1200,801\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;4&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;NIKON D800E&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;1527659603&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;70&quot;,&quot;iso&quot;:&quot;280&quot;,&quot;shutter_speed&quot;:&quot;0.004&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Ureteral stricture: Causing and Treatment\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;After we gather all required informations, then we discuss with the patient about the treatment which tailor-made for individuals.&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Doctor-talking.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Doctor-talking.jpg?resize=800%2C534&#038;ssl=1\" alt=\"Urologist discussing imaging results and treatment options with a patient\" class=\"wp-image-6067\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Doctor-talking.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Doctor-talking.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Doctor-talking.jpg?resize=1024%2C684&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Doctor-talking.jpg?resize=768%2C513&amp;ssl=1 768w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Doctor-talking.jpg?resize=18%2C12&amp;ssl=1 18w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/02\/Doctor-talking.jpg?resize=750%2C501&amp;ssl=1 750w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">The choice depends on the cause, the length of the narrowing and how much function the kidney still has.<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">Symptoms that are an emergency<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>An obstructed kidney that becomes infected is a urological emergency.<\/strong> Antibiotics alone are not enough \u2014 the system has to be drained urgently, and delay is dangerous. In an emergency in Thailand, call <strong>1669<\/strong>.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Fever or shaking chills with flank pain<\/strong>, particularly if you are known to have a narrowing or a stent \u2014 go to hospital the same day, not to a clinic the following week.<\/li>\n\n\n\n<li>Feeling profoundly unwell, confused, or faint alongside a fever.<\/li>\n\n\n\n<li>Passing little or no urine, especially if you have one kidney or both sides are affected.<\/li>\n\n\n\n<li>Severe flank pain with vomiting.<\/li>\n\n\n\n<li>A stent that was due to be changed and has been forgotten. <strong>A stent left in far beyond its due date encrusts, blocks and can be very difficult to remove<\/strong> \u2014 this is one of the commonest avoidable disasters in urology.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Frequently Asked Questions About Ureteral Stricture<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">I feel completely well. Does the narrowing still need treating?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Possibly, and feeling well does not answer the question. The other kidney compensates so effectively that a gradually obstructed kidney can be destroyed without causing any symptoms or abnormal blood tests. The decision rests on a renal function scan showing what that kidney is contributing and whether it is genuinely obstructed.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Is this the same as a urethral stricture?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">No. A ureteral stricture narrows the tube between kidney and bladder and threatens the kidney. A urethral stricture narrows the tube from the bladder to the outside and causes a weak urinary stream. The names are similar and the conditions are unrelated.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Is it permanent?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Often not. Reconstruction cures the narrowing definitively in many people, and an earlier version of this article described the condition as generally lifelong, which was too pessimistic. Long strictures, those caused by radiation, and situations where major surgery is unwise are more often managed than cured.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Can it be fixed without open surgery?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Sometimes. Endoscopic dilatation or incision works best for short, recent strictures with an intact blood supply and is considerably less reliable otherwise, with recurrence common. Reconstruction is frequently performed robotically, which means a small-incision operation rather than a lesser one.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">What if the kidney is already destroyed?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Then reconstructing the ureter serves no purpose. A non-functioning kidney does not automatically need removing; it is taken out when it causes recurrent infection, pain or high blood pressure, and otherwise it is often left alone.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Arranging a consultation<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Dr. Soarawee Weerasopone is a fellowship-trained robotic and reconstructive urologist at <a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\">Bangkok Hospital Headquarters<\/a>, and also sees patients at Samitivej Sriracha Hospital in Chonburi on <a href=\"tel:0880221445\">088-022-1445<\/a>. Bring the imaging itself rather than the reports where possible, along with details of any previous stone treatment or abdominal surgery \u2014 the operation note is often the single most useful document.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bangkok Hospital Telemedicine is available for patients who cannot attend in person, including international patients \u2014 arrange it in advance by email to the Urology department at <a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a>. Samitivej Sriracha is in-person only. Enquiries about cost are answered by the hospital, not by this website.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Disclaimer:<\/strong> This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters, and is intended for education only. It is not medical advice, diagnosis or a prescription for any individual, and no advice, diagnosis or prescription is given through personal messaging channels or social media. Dr. Soarawee operates no public social media account; any account offering private consultation in his name is fraudulent. In an emergency in Thailand, call <strong>1669<\/strong>.<\/p>\n\n\n\n<script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\",\n  \"@graph\": [\n    {\n      \"@type\": \"MedicalWebPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2023\/02\/26\/ureteral-stricture-causing\/#webpage\",\n      \"url\": \"https:\/\/drsoaraweeurology.com\/2023\/02\/26\/ureteral-stricture-causing\/\",\n      \"name\": \"Ureteral Stricture: How a Narrowed Ureter Can Destroy a Kidney Silently\",\n      \"description\": \"A narrowed ureter often causes no symptoms because the opposite kidney compensates, allowing silent loss of function. Causes, the renal function scan that decides management, and treatment from stent to robotic reconstruction.\",\n      \"inLanguage\": \"en\",\n      \"datePublished\": \"2023-02-26\",\n      \"dateModified\": \"2026-08-25\",\n      \"isPartOf\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#website\" },\n      \"author\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"reviewedBy\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"publisher\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/#physician\" },\n      \"about\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/2023\/02\/26\/ureteral-stricture-causing\/#ureteral-stricture\" },\n      \"audience\": { \"@type\": \"MedicalAudience\", \"audienceType\": \"Patient\" },\n      \"disambiguatingDescription\": \"The earlier version of this article was written as a clinical framework and contained no symptoms, no named investigations and no named treatments. The central hazard, that a gradually obstructed kidney can be destroyed without symptoms or abnormal blood tests because the opposite kidney compensates, was absent and is now the leading section. The description of ureteral stricture as generally a lifelong condition was unduly pessimistic and has been corrected, since reconstruction is curative in many cases. The renal function scan, infected obstruction as an emergency requiring urgent drainage, and the hazard of an overdue ureteric stent have been added.\"\n    },\n    {\n      \"@type\": \"MedicalCondition\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2023\/02\/26\/ureteral-stricture-causing\/#ureteral-stricture\",\n      \"name\": \"Ureteral stricture\",\n      \"description\": \"Fibrotic narrowing of the ureter causing upstream obstruction and hydronephrosis. Frequently asymptomatic because contralateral renal compensation maintains normal serum creatinine, permitting silent loss of ipsilateral function.\",\n      \"cause\": \"Impacted calculus and ureteroscopic instrumentation; iatrogenic injury or devascularisation during gynaecological, colorectal or vascular surgery; pelvic radiotherapy; urothelial or extrinsic malignancy including cervical and colorectal cancer; periureteric fibrosis from endometriosis, aortic aneurysm or retroperitoneal fibrosis; genitourinary tuberculosis; and idiopathic cases.\",\n      \"typicalTest\": [\n        {\n          \"@type\": \"MedicalTest\",\n          \"name\": \"Renal function scan (MAG3 renogram)\",\n          \"description\": \"Determines split renal function and confirms whether the dilated system is genuinely obstructed. Decisive in choosing between reconstruction, observation and nephrectomy.\"\n        },\n        {\n          \"@type\": \"MedicalTest\",\n          \"name\": \"CT urogram\",\n          \"description\": \"Defines the site and length of the stricture and identifies extrinsic or urothelial malignancy.\"\n        }\n      ],\n      \"possibleComplication\": \"Progressive silent loss of renal function; recurrent urinary infection; and infected obstruction, which is a urological emergency requiring urgent drainage rather than antibiotics alone. An overdue ureteric stent may encrust, obstruct and become difficult to retrieve.\",\n      \"possibleTreatment\": {\n        \"@type\": \"MedicalProcedure\",\n        \"name\": \"Management options\",\n        \"howPerformed\": \"Observation where split function is negligible and the patient is asymptomatic; ureteric stent or percutaneous nephrostomy for drainage; endoscopic dilatation or endoureterotomy for short, recent strictures with intact vascularity; and definitive reconstruction by excision and anastomosis, ureteric reimplantation, psoas hitch or Boari flap, or graft ureteroplasty, increasingly performed robotically.\"\n      }\n    },\n    {\n      \"@type\": \"FAQPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2023\/02\/26\/ureteral-stricture-causing\/#faq\",\n      \"isPartOf\": { \"@id\": \"https:\/\/drsoaraweeurology.com\/2023\/02\/26\/ureteral-stricture-causing\/#webpage\" },\n      \"mainEntity\": [\n        {\n          \"@type\": \"Question\",\n          \"name\": \"I feel completely well. Does a ureteral stricture still need treating?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Possibly, and feeling well does not answer the question. The opposite kidney compensates so effectively that an obstructed kidney can be destroyed without symptoms or abnormal blood tests. A renal function scan showing split function and whether obstruction is genuine is what decides management.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"Is a ureteral stricture the same as a urethral stricture?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"No. A ureteral stricture narrows the tube between kidney and bladder and threatens the kidney. A urethral stricture narrows the tube from the bladder to the outside and causes a weak urinary stream.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"Is a ureteral stricture permanent?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Often not. Reconstruction cures the narrowing definitively in many people. Long strictures, radiation-induced strictures and situations where major surgery is unwise are more often managed than cured.\" }\n        },\n        {\n          \"@type\": \"Question\",\n          \"name\": \"What if the kidney is already destroyed?\",\n          \"acceptedAnswer\": { \"@type\": \"Answer\", \"text\": \"Reconstruction then serves no purpose. A non-functioning kidney does not automatically require removal; it is taken out when it causes recurrent infection, pain or hypertension, and otherwise is often left alone.\" }\n        }\n      ]\n    }\n  ]\n}\n<\/script>\n","protected":false},"excerpt":{"rendered":"<p>\u1000\u103b\u1031\u102c\u1000\u103a\u1000\u1015\u103a\u1019\u103e \u1006\u102e\u1038\u1021\u102d\u1019\u103a\u101e\u102d\u102f\u1037 \u1006\u1000\u103a\u101e\u103d\u101a\u103a\u1011\u102c\u1038\u101e\u1031\u102c \u1015\u102d\u102f\u1000\u103a \u1000\u103b\u1009\u103a\u1038\u1019\u103c\u1031\u102c\u1004\u103a\u1038\u101e\u103d\u102c\u1038\u1001\u103c\u1004\u103a\u1038\u101e\u100a\u103a \u1021\u1001\u103c\u102c\u1038\u1000\u103b\u1031\u102c\u1000\u103a\u1000\u1015\u103a\u1000 \u1010\u102d\u1010\u103a\u1010\u1006\u102d\u1010\u103a \u1010\u102c\u101d\u1014\u103a\u101a\u1030\u101c\u102f\u1015\u103a\u1006\u1031\u102c\u1004\u103a\u1015\u1031\u1038\u1014\u1031\u101e\u1031\u102c\u1000\u103c\u1031\u102c\u1004\u1037\u103a \u101b\u1031\u102c\u1002\u102b\u101c\u1000\u1039\u1001\u100f\u102c \u101c\u102f\u1036\u1038\u101d\u1019\u1015\u103c\u1010\u1010\u103a\u1015\u102b\u104b \u1010\u1005\u103a\u1005\u102f\u1036\u1010\u1005\u103a\u101b\u102c\u1000\u102d\u102f \u101e\u1010\u102d\u1015\u103c\u102f\u1019\u102d\u1001\u103b\u102d\u1014\u103a\u1010\u103d\u1004\u103a \u1011\u102d\u102f\u1018\u1000\u103a\u1001\u103c\u1019\u103a\u1038\u104f \u101c\u102f\u1015\u103a\u1006\u1031\u102c\u1004\u103a\u1001\u103b\u1000\u103a\u1019\u103e\u102c \u1006\u102f\u1036\u1038\u101b\u103e\u102f\u1036\u1038\u1014\u103e\u1004\u1037\u103a\u1015\u103c\u102e\u1038 \u1016\u103c\u1005\u103a\u1014\u102d\u102f\u1004\u103a\u1015\u102b\u101e\u100a\u103a\u104b \u1011\u102d\u102f\u1037\u1000\u103c\u1031\u102c\u1004\u1037\u103a \u1000\u103b\u1031\u102c\u1000\u103a\u1010\u100a\u103a\u1001\u103c\u1004\u103a\u1038 \u101e\u102d\u102f\u1037\u1019\u101f\u102f\u1010\u103a \u1010\u1004\u103a\u1015\u102b\u1038\u1006\u102f\u1036\u1010\u103d\u1004\u103a\u1038 \u1001\u103d\u1032\u1005\u102d\u1010\u103a\u1000\u102f\u101e\u1019\u103e\u102f\u1019\u103b\u102c\u1038 \u1015\u103c\u102f\u101c\u102f\u1015\u103a\u1015\u103c\u102e\u1038\u1014\u1031\u102c\u1000\u103a \u1006\u1000\u103a\u101c\u1000\u103a\u104d \u1015\u102f\u1036\u101b\u102d\u1015\u103a\u1016\u1031\u102c\u103a\u1005\u1005\u103a\u1006\u1031\u1038\u1019\u103e\u102f\u1019\u103b\u102c\u1038 \u1001\u1036\u101a\u1030\u101b\u1014\u103a \u1021\u101c\u103d\u1014\u103a\u1021\u101b\u1031\u1038\u1000\u103c\u102e\u1038\u1015\u102b\u101e\u100a\u103a\u104b.<\/p>","protected":false},"author":185281453,"featured_media":10111,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"advanced_seo_description":"A narrowed ureter can damage a kidney without any symptoms. 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