Pd55-01 Our 10 Year Diagnostic and Therapeutic Approach to Primary Obstructive Megaureter: The Endoscopic Balloon Dilation

You have accessJournal of UrologyPediatrics VI (PD55)1 May 2024PD55-01 OUR 10 YEAR DIAGNOSTIC AND THERAPEUTIC APPROACH TO PRIMARY OBSTRUCTIVE MEGAURETER: THE ENDOSCOPIC BALLOON DILATION Gunter De Win, Quinten Bogaerts, Koen Van Hoeck, Dominique Trouet, Stefan De Wachter, and Karen De Baets Gunter De WinGunter De Win , Quinten BogaertsQuinten Bogaerts , Koen Van HoeckKoen Van Hoeck , Dominique TrouetDominique Trouet , Stefan De WachterStefan De Wachter , and Karen De BaetsKaren De Baets View All Author Informationhttps://doi.org/10.1097/01.JU.0001008908.82706.9f.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Several Mega-ureters resolve spontaneously. However, some progressive ones have an impact on declining differential renal function or become symptomatic. Those require treatment: reimplantation or ureterostomy. We first start with an endoscopic balloon dilation. With this study we want to describe our 10 year experience with Endoscopic Balloon Dillatation for Primary Obstructive Megaureter. METHODS: Children needing intervention for POM (based on increasing distal dilatation and DRF <40% or symptoms) were counseled to undergo a trial of Endoscopic Balloon Dillatation. If the balloon could not be inserted, a more invasive procedure (eg reimplantation or ureterostomy) were performed. A 9.5Fr cystoscope and stent 'pusher' was used to insert a 14'' guidewire to allow insertion of a 4/25 mm coronary dilatation balloon which was insufflated to 15 ATM for 5 minutes. Afterwards a 4.7Fr DJstent was positioned across the VUJ for 6 weeks. If deemed necessary, a second dilation was performed. Ureteric diameter, DRF, length of obstruction, complications and need for further intervention were registered. Success was defined as improvement of the indication without further need for a more invasive procedure. RESULTS: 31 dilated ureters in 28 patients (23/5 M/F) were included with a median age of 9 months (range 1-111) and a follow up of 41 months (range 12-84). EBD showed a stenotic ring in 29 (93.5%) and longer narrow segments in 2 (6%). In 3 (9.6%) only a 3.7Fr stent could be placed. EBD was successful in 29/31 ureters (93.5%). In 8 ureters, a second dilation was performed. Diameter of the distal ureter improved in 96%. Two failures (one with a narrow distal ureter rather than stenotic ring) needed a ureterostomy or reimplant. 3 (10%) patients developed a UTI with the DJstent in situ and 2 (6%) uretero-renoscopic stent retrievals were needed. One of these had a completely calcified DJ stent, needing an nephrostomy. CONCLUSIONS: As most POM resolve spontaneously, hard indications are needed before treatment is offered. Symptomatic patients (eg. Infections) and declining DRF with dilated ureters are strong indications. In those cases, endoscopic balloon dilatation with a coronary dilatation balloon has a high success rate and provides diagnostic information about the length of the narrow ureteric segment. Longer narrow distal ureteric segments are rare but result in a higher failure rate. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1150 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Gunter De Win More articles by this author Quinten Bogaerts More articles by this author Koen Van Hoeck More articles by this author Dominique Trouet More articles by this author Stefan De Wachter More articles by this author Karen De Baets More articles by this author Expand All Advertisement PDF downloadLoading ...