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Primary obstructive megaureter in infants: our experience with endoscopic balloon dilation and cutting balloon

Nicola Capozza1, Giovanni Torino, Simona Nappo

  • 1Surgical Unit of the Pediatric Urology, "Bambino Gesù" Children's Hospital and Research Institute , Rome, Italy .

Journal of Endourology
|March 21, 2014
PubMed

Insights

Endoscopic treatment for primary obstructive megaureter (POM) shows promise. High-pressure balloon dilation and cutting balloon ureterotomy effectively resolved stenosis in most cases, offering a viable surgical option.

Area of Science:

  • Pediatric Urology
  • Minimally Invasive Surgery
  • Endourology

Background:

  • Primary obstructive megaureter (POM) management is often conservative in infants.
  • High-grade POM with dilation, obstructive renography, or reduced renal function necessitates surgical intervention.

Purpose of the Study:

  • To evaluate the efficacy of endoscopic management for primary obstructive megaureter.
  • To assess the outcomes of endoscopic high-pressure balloon dilation (EHPBD) and cutting balloon ureterotomy (CBU) for POM.

Main Methods:

  • Retrospective analysis of 12 patients (6-12 months old) treated endoscopically for POM between January 2009 and March 2013.
  • Procedures included identification of stenotic rings, EHPBD, and CBU for persistent rings.
  • Mean follow-up was 21 months.

Main Results:

  • A stenotic ring was identified in 10 of 12 patients.
  • EHPBD was successful in 7 patients.
  • CBU for persistent rings resulted in complete stenosis resolution.
  • Overall success rate for EHPBD+CBU was 83%.

Conclusions:

  • Endoscopic treatment is a viable option for primary obstructive megaureter.
  • CBU is an effective definitive treatment for POM with persistent rings unresponsive to EHPBD.

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