New possibilities for ureteric dilatation
A method is described for the treatment of ureteric strictures following a principle in which use is made of a cannulated polyvinyl bougie introduced over a previously inserted ureteric catheter. In our experience the method has proved to be applicable to all varieties of ureteric stricture once a successful passage of ureteric catheter of no smaller size than 4 Fr. has been produced. Two types of dilator are described for use in the treatment of high and low strictures, respectively, of which that for the low strictures has also proved of use for the introduction of a catheter, when this had been impossible by the normal method on account of the presence of the stenosis. The instruments have also been used to facilitate the passage or extraction of ureteric calculi. In 37 cases (21 strictures at varying levels, long and short, and in 2 cases double, 16 cases of ureteric stone) the method has been eminently successful; when used, however, for the introduction of a catheter into a stenotic ureter, as mentioned previously, less uniform success is to be expected.