ABSTRACT
The natural history and outcome of intervention for obstructive uropathy were studied retrospectively in 20 patients managed at the Department of Urology, Singapore General Hospital between 1991 and 1997. The diagnoses of these strictures were made between 10 months and 21 years after the initial treatment. There were 9 (45%) malignant and 11 (55%) benign strictures. The site of ureteric obstruction was in the lower ureter in 15 patients, in the middle ureter in 3 patients and in the upper ureter in 2 patients. Comparisons between malignant and benign strictures showed that patients with higher original stage of tumour were more likely to have malignant strictures. Besides latency period between primary treatment of the tumour and diagnosis of uropathy, bilaterality and site of strictures showed no discernible difference between benign and malignant strictures. Ureteric stenting provided good outcome in 5 patients with benign strictures and in 3 patients with malignant strictures. Open surgical reconstruction was performed on 2 patients with benign strictures and 2 patients with malignant strictures. All these four patients showed good outcome. Ureteric stenting is an acceptable treatment of benign ureteric stricture and for selected patients with malignant strictures. Open surgery is recommended in patients with benign strictures who could not be treated successfully on stenting.Radiotherapy is the mainstay treatment for locally advanced carcinoma of the cervix. It is also administered as an adjuvant therapy to patients deemed at high risk for local recurrence after radical hysterectomy.
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