Abstract
PURPOSE: We aimed to evaluate the factors predictive of ureteral stenosis after orifice resection and to determine whether ureteral stenting is effective in preventing it. METHODS: The data of patients who underwent transurethral resection of bladder tumor (TUR-BT) in the clinics of two tertiary centers between June 2020 and January 2024 were retrospectively reviewed. Patients who underwent orifice resection due to tumor involvement of the ureteral orifice or too close to it were included in the study. During follow-up, cystoscopy ± diagnostic ureterorenoscopy was performed in patients with hydronephrosis. Ureteral stenosis was defined as a narrowing that precluded the passage of the ureterorenoscope and where no tumoral lesion was detected at the orifice site. RESULTS: A total of 96 patients were included in the study. A D-J stent was inserted in 49 (51%) of the patients following TUR-BT. At a median follow-up of 30 months, metachronous upper urinary tract urothelial carcinoma developed in 8 (8.3%) patients and ureteral stenosis in 11 (11.5%) patients. Ureteral stenosis developed in 2 (4.1%) patients who underwent D-J stent placement versus 9 (19.1%) patients who did not, a difference that was significant. Age, tumor diameter, presence of carcinoma in situ (CIS), and bladder tumor progression rate were significantly higher in patients with ureteral stenosis. In multivariate logistic regression analysis, only the presence of CIS was identified as an independent predictor of ureteral stenosis. CONCLUSION: Although the rate of ureteral stenosis was significantly lower in patients who underwent ureteral stenting, only the presence of CIS was identified as an independent predictor of ureteral stenosis.