Classification of and techniques for the reconstitution of acquired strictures in the region of the ureteropelvic junction.

We performed percutaneous intrarenal surgery on 22 patients with acquired strictures of various degrees of severity in the region of the ureteropelvic junction. Of 17 patients with strictures through which a guide wire could be passed (type 1) 8 (47 per cent) had good or excellent long-term results. Of 4 patients with strictures that were patent radiologically but through which a guide wire could not be passed (type 2) only 1 (25 per cent) had good long-term results. The patient with a stricture that totally obliterated the lumen (type 3) suffered recurrence. We conclude that percutaneous techniques for the management of acquired strictures in the region of the ureteropelvic junction can be difficult technically and currently are most successful in the treatment of strictures of short duration that occur after pyeloplasty.