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Endobrst: simple and safe is best

N Oakley1, A Raza, A U Haq

  • 1Royal Hallamshire Hospital, Sheffield, UK.

Journal of Endourology
|December 10, 1998
PubMed
Summary

Balloon dilatation for ureteropelvic junction (UPJ) obstruction offers a minimally invasive option with encouraging medium-term results. While success rates are lower than open pyeloplasty, this simple procedure has significantly less morbidity.

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Endourology

Background:

  • Ureteropelvic junction (UPJ) obstruction treatment is evolving towards complex minimally invasive techniques.
  • The role of simpler procedures like balloon dilatation for UPJ obstruction warrants examination.

Purpose of the Study:

  • To evaluate the symptomatic and renographic outcomes of balloon dilatation for UPJ obstruction.
  • To assess the efficacy and morbidity of balloon disruption of the UPJ.

Main Methods:

  • Prospective audit of 21 renal units (20 patients) undergoing balloon dilatation for UPJ obstruction.
  • Clinical follow-up and Diethylene Triamine Pentaacetic Acid (DTPA) renograms were used to assess outcomes at 6 to 30 months post-procedure.

Main Results:

  • 81% of patients remained asymptomatic at 6 months post-procedure.
  • Renographic split function improved in 11 renal units, and excretion improved in 14.
  • A 14% nephrectomy rate was observed, primarily in patients with poor baseline renal function.

Conclusions:

  • Balloon dilatation is a simple procedure with encouraging medium-term results and significantly less morbidity compared to open pyeloplasty.
  • Careful patient selection is crucial; balloon dilatation is not recommended as a salvage procedure for patients with inevitable nephrectomy.
  • The technique has a quick learning curve and remains a viable option for selected UPJ obstruction cases.

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