Balloon dilation for failed pyeloplasty in children?

Abstract

Objective:Pyeloplasty is considered the gold standard treatment for ureteropelvic junction obstruction (UPJO). However, the failure rate of pyeloplasty is as high as 10% and repeat pyeloplasty is more difficult. This study aimed to evaluate the efficacy of balloon dilatation for failed pyeloplasty in children.Materials and Methods:Between 2011 and 2017, 15 patients, aged 6 months to 14 years, were treated with balloon dilation for restenosis of UPJO after a failed pyeloplasty. Ultrasound and intravenous urography were used to evaluate the primary outcome. Success was defined as the relief of symptoms and improvement of hydronephrosis, which was identified by ultrasound at the last follow-up.Results:All patients successfully completed the operation, 13 patients by retrograde approach and 2 patients by antegrade approach. Thirteen patients were followed for a median of 15 (4 to 57) months and 2 patients were lost to follow-up. Resolution of the hydronephrosis was observed in 5 cases. The anteroposterior diameter (APD) of the pelvis decreased by an average of 12.4 ± 14.4mm. Eight patients needed another surgery. The average postoperative hospital stay was 1.78 ± 1.4 days. Two patients experienced fever after balloon dilation. No other complications were found.Conclusions:Balloon dilatation surgery is safe for children, but it is not recommended for failed pyeloplasty in that group of patients, owing to the low success rate.

A Nomogram to Predict Stricture-free Survival in Patients with Ureteral Stricture after Balloon Dilation

“…[3 6-10] M.J.van Son's study reported that the stricture side was an independent risk factor for stricture recurrence (P = 0.009, HR 0.35, 95%CI 0.16-0.77). [1] However, there was no signi cant difference in SFS between patients with left ureter stricture and those with the right ureter stricture in our study (P = 0.504). Interestingly, our results found no signi cant difference in SFS between one and two stents retention (P = 0.293).…”

“…Ureteral stenosis is a well-known long-term complication that can impair kidney function, mainly caused by various factors, including benign or malignant. [1] Benign ureteral stricture occurred mainly after pelvic and abdominal surgery, ureteral injuries from lithiasis and endoscopic operation, infections, retroperitoneal brosis, renal transplantation, urinary diversion, endometriosis, neurogenic bladder disorder, and idiopathic causes. [2][3][4] Urothelial carcinoma, prostatic, ovarian, metastatic cervical, breast, and colorectal cancer are the primary causes of another type of ureteral stricture: malignant ureteral stenosis.…”

A nomogram to predict stricture-free survival in patients with ureteral stricture after balloon dilation

“…Author details 1 Department of Urology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 West Yanjiang Road, Guangzhou 510210, China. 2 Guangdong Provincial Clinical Research Center for Urological Diseases, Guangzhou, China.…”