Balloon dilatation of the pelviureteric junction in children: early experience and pitfalls

Early experience with minimally invasive procedures performed on children with pelviureteric junction obstruction is described. Balloon dilatation of the pelviureteric junction was performed in children aged between 5 months and 10 years. Ten procedures were performed in nine children, six for pelviureteric junction obstruction and four for stricture following surgical pyeloplasty. In none of the cases was a stent inserted following the procedure. In two cases the procedure was performed by antegrade approach following nephrostomy and in eight cases by retrograde approach following cystoscopy. In four cases the procedure was successful with relief of symptoms and/or improvement in radiological appearance, in three cases the radiological appearance was unchanged and in three cases the procedure resulted in complete obstruction of the pelviureteric junction requiring surgical intervention. Two of the retrograde procedures resulted in vesicoureteric junction obstruction, one requiring reimplantation and the other nephrectomy. We recommend the antegrade approach to avoid trauma to the vesicoureteric junction, and our results suggest that stenting is necessary to prevent early obstruction.