Interventional radiology in the treatment of uretero-pelvic-junction

Numerous authors have reported successful results with both antegrade or retrograde endopyelotomy. Both procedures have proved to be efficient in primary as in secondary obstructions. Some additional etiological factors, such as crossing vessels high-grade hidronephrosis and poorly functioning kidney, may decrease the success rate of these minimally invasive techniques. The development of a cutting balloon catheter used under fluoroscopic control simplified the retrograde technique. This technique proved to be easier to perform than antegrade or retrograde endoscopic incision and did not require specialized instrumentation. In our experience 6 patients from 30 to 65 years old (average age 52) with an ureteropelvic-junction obstruction secondary to open surgery underwent endopyelotomy with the cutting balloon device. At the three month followup 4 patients had renographic patent ureteropelvic junction and no modifications were seen at one year follow up The retrograde endopyelotomy under fluoroscopic control seems to offer a rapid and effective treatment of UPJO. It is indicated for all primary and secondary UPJO obstruction apart forpatients with a concomitant renal stone or with high-insertion ureteropelvic junction.