17 Review Article Page 1 of 17 Narrative review of the current management of radiation-induced ureteral strictures of the pelvis Pooja Srikanth1^, Hannah E. Kay1^, Adan N. Tijerina1^, Arjun V. Srivastava1^, Aaron A. Laviana1,2^, J. Stuart Wolf Jr1,2^, E. Charles Osterberg1,2^ 1University of Texas Dell Medical School, Austin, TX, USA; 2Dell Medical School Department of Surgery and Perioperative Care, and Ascension Seton Hospital Network, Austin, TX, USA Contributions: (I) Conception and design: EC Osterberg, P Srikanth; (II) Administrative support: EC Osterberg, AA Laviana, JS Wolf Jr; (III) Provision of study materials or patients: None; (IV) Collection and assembly of data: P Srikanth, HE Kay, AN Tijerina, AV Srivastava; (V) Data analysis and interpretation: P Srikanth, HE Kay, AN Tijerina, AV Srivastava; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Pooja Srikanth. University of Texas Dell Medical School, 1501 Red River St., Austin, TX 78712, USA. Email:
[email protected]. Abstract: Radiation therapy to the pelvis is indicated for cervical, prostate, rectal, and gastrointestinal (GI) malignancies. A rare, but known adverse effect of this treatment is radiation-induced ureteral stricture (RIUS). RIUS can cause infection, hydronephrosis, kidney stone formation, and ultimately, renal failure. Management of RIUS is a challenge to urologists as the strictures tend to be long, bilateral, and ischemic in etiology. Management of RIUS is divided into endoscopic, open, and minimally invasive techniques. Stents and percutaneous nephrostomy (PCN) tubes are generally used as temporizing measures until definitive repair, but they may be a long-term option for patients unfit for surgery.