Endoluminal ultrasonography with reusable probe: preliminary results

Endoluminal ultrasound probes have been disposable, making their regular use costly. We describe the technique and preliminary results of a reusable endoluminal ultrasound probe for examining ureteral anatomy.

The 2.4-mm (7.2F) or 3-mm (9F) probe (Olympus, Tokyo) is passed up the ureter after a retrograde ureteropyelogram has been obtained. No intraoperative preparation of the probe is needed. An axial image as little as 1 cm or as much as 10 cm around the ureter can be obtained. Over the last 20 months, 50 procedures using endoluminal ultrasonography were performed in our unit: 36 (72%) for uretero-pelvic junction (UPJ) obstruction, 10 (20%) for upper-tract filling defects, and the remaining 4 (8%) for ureteral strictures.

Endoluminal ultrasonography detected crossing vessels at the UPJ in 19 (53%) and a septum in 9 (25%) of the 36 renal units with UPJ obstruction. In eight of the 36 renal units with UPJ obstruction (22%), endopyelotomy was not done because of the presence of crossing vessels. A further 4 renal units (11%) had the direction of the incision modified because of the ultrasound findings. In the cases with upper-tract transitional-cell carcinoma, images correlated well with the nephroureterectomy specimen. The probe had to be replaced twice.

This endoluminal ultrasound system produces clear images of the ureteral and periureteral anatomy. The reusable aspect of the probe removes an important obstacle to its common use for evaluating a variety of upper urinary tract abnormalities.