Related Experiment Video
Updated: May 5, 2026
Surgical Management of Meatal Stenosis with Meatoplasty
Published on: November 30, 2010
Long-Term Outcomes of Balloon Dilation in Pediatric Distal Ureteral Stenosis Across Age Groups
Keyu Ouyang1, Yikui Zhang1, Sai Ma1
1Department of Pediatric Urology, Guangdong Women and Children Hospital, Guangzhou, China.
Insights
Balloon dilation is an effective treatment for pediatric distal ureteral segment stenosis, particularly in newborns. Treatment success for this condition is influenced by patient age and specific anatomical factors.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Ureteral Stricture Disease
Background:
- Primary obstructive megaureter treatment typically involves ureteral reimplantation, with debate on its use in infants.
- Ureterostomy is often preferred for urinary diversion in primary obstructive megaureter cases.
- Balloon dilation, successful in adults, presents a potential alternative for pediatric ureteral strictures.
Purpose of the Study:
- To evaluate balloon dilation's effectiveness in pediatric distal ureteral segment stenosis.
- To analyze pre- and postoperative parameters in different pediatric age groups.
- To identify factors influencing treatment success.
Main Methods:
- Retrospective analysis of 19 newborns, 29 young infants, and 29 children with distal ureteral segment stenosis.
- Patients underwent balloon dilation (8-10.5 F) between December 2020 and November 2023.
- Data collected included age, sex, laterality, and pre/postoperative parameters.
Main Results:
- Distal ureteral segment stenosis is more prevalent in males and on the left side.
- Balloon dilation showed significant therapeutic effects across all pediatric age groups.
- Outcomes were most favorable in newborns, followed by young infants and children.
- Treatment success correlated with age, hydronephrosis, renal cortical thickness, and ureteral dilation.
Conclusions:
- Balloon dilation is a viable and effective treatment for pediatric distal ureteral segment stenosis, especially in newborns.
- Age and specific anatomical factors like hydronephrosis and ureteral dilation independently impact treatment outcomes.
- This minimally invasive approach offers a promising alternative to traditional surgical methods.
Purposes:
The gold standard for treating primary obstructive megaureter is ureteral reimplantation, with ongoing debate surrounding its use in patients under 1 year of age. In most primary obstructive megaureter cases requiring urinary diversion, ureterostomy is favored over pyelostomy and nephrostomy. Another described alternative would be the refluxing ureteral reimplantation. Balloon dilation, established as effective and safe in adults with ureteral strictures, may offer an alternative for pediatric patients. This study aims to evaluate pre- and postoperative parameters of balloon dilation in distal ureteral segment stenosis among pediatric patients across age groups and to identify independent parameters influencing treatment success.
Methods:
The medical records of newborns (age, 0-28 days; n = 19), young infants (age, 28 days to 6 months; n = 29), and children (age, 6 months to 11 years; n = 29) of Han Chinese pediatric patients from the Guangdong Women and Children Hospital, Guangzhou, China, from December 8, 2020, to November 5, 2023, with distal ureteral segment stenosis who underwent balloon dilatation (size from 8 to 10.5 F) were included in the analysis.
Findings:
The prevalence of distal ureteral segment stenosis is higher in males than females (58 vs 19) and that was higher on the left lateral side in both boys and girls than right or both lateral sides (P = 0.0375). The therapeutic effect of balloon dilation in distal ureteral segment stenosis is effective across all age groups (P < 0.05 for all) and especially reported to be more effective in newborns, followed by young infants and children regarding anterior and posterior pelvic diameter, renal parenchymal thickness (thinnest point), ureter diameter (widest point), and urine white blood cells (P < 0.05 for all). The treatment effect of balloon dilation correlated with age (P = 0.0412), hydronephrosis (P = 0.0481), renal cortical thickness (P = 0.0419), and ureteral dilation (P = 0.0491).
Implications:
These findings suggest that balloon dilation may offer a manageable alternative for younger patients, especially newborns for distal ureteral segment stenosis, with age and specific anatomical factors influencing outcomes. Age, hydronephrosis, renal cortical thickness, and ureteral dilation were independent parameters for the treatment effect of balloon dilation in very young patients.
