Retrograde balloon dilatation for pelviureteric junction obstruction: long-term follow-up

The results of 10 years' experience of treating pelviureteric junction (PUJ) obstruction by balloon dilatation are reviewed, and recommendations about the suitability of the technique for individual patients are made based on the patient's history and a preoperative DTPA renogram. Of 76 patients, 32 (42%) had no further symptoms after balloon dilatation. Six (8% continued to have mild loin pain only. In 33 patients (43%), there was no improvement in symptoms, split renal function, or drainage. Of this group, 21 patients (28%) underwent repeat balloon dilatation. Nine (12% became asymptomatic, and a further four (5%) had only minimal residual symptoms. The overall success rate of the procedure in terms of symptomatic abolition or improvement thus was 67%. Patients with < 25% function in the affected kidney preoperatively or who had undergone a previous pyeloplasty were the most likely to require additional treatment. No deaths were recorded, and morbidity was minimal.