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Antegrade balloon dilation of postoperative ureterovesical junction obstruction in children

C A Angel1, J N Kocurek, E M Walser

  • 1Department of Surgery, Division of Pediatric Surgery, The University of Texas Medical Branch, 77555-0353, Galveston, Texas, USA.

Pediatric Surgery International
|September 24, 2013
PubMed

Insights

Antegrade balloon dilation (ABD) offers a minimally invasive treatment for ureterovesical junction obstruction following ureteral reimplantation in children. This approach shows promise as a primary therapy, potentially reducing the need for surgical correction.

Area of Science:

  • Pediatric Urology
  • Minimally Invasive Surgery
  • Urological Complications

Background:

  • Ureteral reimplantation can lead to ureterovesical junction obstruction, a known complication.
  • Traditional treatment involves surgical correction, which can be invasive.

Purpose of the Study:

  • To evaluate the efficacy and safety of antegrade balloon dilation (ABD) for treating ureterovesical junction obstruction in children.
  • To explore ABD as a potential first-line treatment.

Main Methods:

  • Two pediatric patients with post-reimplantation ureteral strictures underwent antegrade balloon dilation (ABD).
  • Obstruction was confirmed using diuretic renography and pressure perfusion studies.
  • Follow-up included clinical assessment, ultrasonography, and repeat diuretic renograms.

Main Results:

  • Ultrasonography demonstrated resolution of hydronephrosis post-ABD.
  • Diuretic renograms confirmed complete radiotracer washout, indicating successful obstruction relief.
  • Morbidity was minimal, consisting of manageable pyelonephritis episodes.

Conclusions:

  • Antegrade balloon dilation (ABD) is a simple, effective, and low-morbidity procedure for distal ureteral obstruction after reimplantation.
  • ABD should be considered a primary treatment modality for these specific ureteral strictures.

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