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Balloon dilation for failed pyeloplasty in children?

Haifeng Duan1,2, Wei Zhu1,2, Wen Zhong1,2

  • 1Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.

International Braz J Urol : Official Journal of the Brazilian Society of Urology
|January 25, 2019
PubMed
Summary

Balloon dilatation is a safe procedure for children with ureteropelvic junction obstruction (UPJO) after failed pyeloplasty. However, its low success rate makes it unsuitable for this patient group.

Keywords:
Angioplasty, BalloonCakut [Supplementary Concept]Child

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Area of Science:

  • Pediatric Urology
  • Minimally Invasive Surgery

Background:

  • Pyeloplasty is the standard treatment for ureteropelvic junction obstruction (UPJO).
  • Repeat pyeloplasty after initial failure presents surgical challenges.
  • The failure rate of primary pyeloplasty can be up to 10%.

Purpose of the Study:

  • To assess the effectiveness of balloon dilatation for UPJO restenosis in children following unsuccessful pyeloplasty.

Main Methods:

  • Retrospective analysis of 15 pediatric patients (6 months–14 years) treated with balloon dilatation for failed pyeloplasty between 2011 and 2017.
  • Evaluation using ultrasound and intravenous urography.
  • Success defined by symptom relief and improved hydronephrosis on ultrasound.

Main Results:

  • Balloon dilatation was technically successful in all patients.
  • Hydronephrosis resolved in 5 cases, with an average APD decrease of 12.4 mm.
  • Eight patients required further surgical intervention, indicating a low success rate.

Conclusions:

  • Balloon dilatation is a safe procedure in pediatric patients.
  • The low success rate limits its recommendation for treating failed pyeloplasty in children.