Retrograde endopyelotomy: A comparison between laser and acucise balloon cutting catheter

Abstract

Endopyelotomy and laparoscopic pyeloplasty are the preferred modalities for treatment of ureteropelvic junction obstruction because of their minimally invasive nature. There are continuous efforts for improving endopyelotomy techniques and outcome. Retrograde access represents the natural evolution of endopyelotomy. The Acucise cutting balloon catheter (Applied Medical Resources Corp., Laguna Hills, CA) and ureteroscopic endopyelotomy using holmium laser are the most widely accepted techniques. The Acucise catheter was developed to simplify retrograde endopyelotomy and made it possible for all urologists, regardless of their endourologic skills. The Acucise catheter depends on incision and dilatation of the ureteropelvic junction under fluoroscopic guidance, whereas ureteroscopy allows visual control of the site, depth, and extent of the incision; the holmium laser is a perfect method for a clean precise incision. Review of the English literature showed that the Acucise technique was more widely performed, though laser had better (but not statistically significant) safety and efficacy profiles.

Diagnosis and management of ureteral complications following renal transplantation

“…A total of 21 patients were treated with a mean follow-up of 19 months (range 13–27 months) and an overall success rate of 78% (range 60%–100%). Although success rates are better when compared to primary balloon dilation, the Acucise device is rarely used because of the bleeding risk associated with blind ureteral incision [21] .…”

Approach to urological complications early post renal transplant

“…For ureteric strictures besides surgical exploration endo-urological techniques has also been evolved and adopted with favorable outcomes. These include ureterotomy and balloon dilatation which has success rate of 70% [10][11][12][13][14][15] and 51% respectively [16][17][18][19].…”