ABSTRACT
Objective:To investigate the risk factors of postoperative persistent ureteral stricture by collecting and analyzing the clinical pathological data of patients after radical hysterectomy.Methods:The clinicopathological data of patients with cervical cancer and endometrial cancer diagnosed in Guangxi Medical University Cancer Hospital from December 2013 to December 2018 who needed radical hysterectomy were retrospectively analyzed, and the incidence of postoperative persistent ureteral stricture, related risk factors and their impact on the prognosis of patients were analyzed.Results:Finally, a total of 1 068 patients were included in the study. Among them, 194 patients developed persistent ureteral stricture after radical hysterectomy, with an overall incidence of 18.2%, of which the incidence of cervical cancer was 18.7%(151/807), and the incidence of endometrial cancer was 16.5%(43/261). There was no significant difference in the incidence of ureteral stricture after radical hysterectomy between the two types of tumors ( P>0.05). Univariate analysis showed that International Federation of Obstetrics and Gynecology (FIGO) stage, postoperative adjuvant chemotherapy, vascular invasion, lymph node metastasis, postoperative adjuvant radiotherapy, postoperative ureteral fistula, postoperative lymphatic cyst, preoperative albumin were associated with persistent ureteral stricture after radical hysterectomy (all P<0.05); Multivariate analysis showed that postoperative adjuvant radiotherapy, postoperative adjuvant chemotherapy, postoperative ureteral fistula and postoperative lymphatic cyst were independent risk factors for persistent ureteral stricture (all P<0.05). There was a statistically significant difference in the survival rate between patients with and without persistent ureteral stricture ( P<0.01). Conclusions:The incidence of persistent ureteral stricture after radical hysterectomy is relatively high in patients with cervical cancer and endometrial cancer, and postoperative ureteral fistula, postoperative adjuvant radiotherapy, postoperative adjuvant chemotherapy and lymphocyst may be independent risk factors. Postoperative persistent ureteral stricture may affect the outcome of patients.