Balloon Dilatation of Iatrogenic Ureteral Strictures after Upper Urinary Tract Reconstruction

Purpose: Open pyeloplasty is the gold standard treatment of uretero-pelvic junction (UPJ) stenosis. Although failure after open pyeloplasty or uretero-neosistosmy is not common, percutaneous or endoscopic interventions must be necessary in some cases. We present treatment of 6 pediatric patients by...

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Bibliographic Details
Main Authors: Enes Duman, Erkan Yildirim, ishak Akillioglu, Selcuk Yucesan
Format: Article
Language:English
Published: Cukurova University 2015-06-01
Series:Çukurova Üniversitesi Tıp Fakültesi Dergisi
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Online Access:http://www.scopemed.org/fulltextpdf.php?mno=171459
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Summary:Purpose: Open pyeloplasty is the gold standard treatment of uretero-pelvic junction (UPJ) stenosis. Although failure after open pyeloplasty or uretero-neosistosmy is not common, percutaneous or endoscopic interventions must be necessary in some cases. We present treatment of 6 pediatric patients by balloon dilatation after failed surgery. Material and Methods: Between 2008 and 2013 6 children were treated. Five patients had undergone open pyeloplasty for UP stenosis and, one has uretero-vesical anastomosis stricture after ureteroneosistostomy. Percutaneous antegrade balloon dilatation and double J stent placement were performed in three of six patients. In the other three patients retrograde endoscopic balloon dilatation and double J stent placement were performed. Results: Primary technical success was %50 and %100 for antegrade and retrograde approach respectively. Antegrade approach has failed in 3 patients (%50) and, retrograde approach and treatment were successful in all of these patients. Secondary and tertiary balloon dilatations were done through antegrade approach in 3 patients. Mean duration of double J stent was 114 days. As of today, five patients are followed smoothly. One patient who has UP stenosis underwent secondary open surgery. Conclusion: Balloon dilatation can be used safely in both antegrade and retrograde approaches because of lower profile of balloon catheters, so it could be considered as a first line treatment option after failed surgical treatment of upper urinary tract stenosis in children. [Cukurova Med J 2015; 40(2.000): 311-316]
ISSN:0250-5150