Balloon catheter dilatation in the treatment of ureteral and ureteroenteric stricture

被引:45
|
作者
Ravery, V [1 ]
De la Taille, A [1 ]
Hoffmann, P [1 ]
Moulinier, F [1 ]
Hermieu, JF [1 ]
Delmas, V [1 ]
Boccon-Gibod, L [1 ]
机构
[1] CHU Bichat, Dept Urol, F-75018 Paris, France
关键词
D O I
10.1089/end.1998.12.335
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Balloon catheter dilatation is a low-cost alternative to open surgery in patients with ureteral strictures, leading to low morbidity and short hospitalization. The goal of this study was to evaluate the results of this technique in patients with inflammatory ureteral strictures or ureteroenteric strictures after radical cystectomy. Twenty-five ureteral strictures in 20 (15 male, 5 female) patients were consecutively treated by high-pressure balloon dilatation: 14 cases of ureteroenteric stricture (9 after ileal cutaneous diversion, and 5 after orthotopic enterocystoplasty) and 11 of ureteral stricture from various inflammatory causes (tuberculosis, iatrogenic injury, radiation therapy, parasitosis), Dilatation was performed by an antegrade (ureteroenteric strictures) or retrograde (inflammatory strictures) approach using a balloon insufflated up to 10 to 20 atm for 5 to 15 minutes. The ureter was stented for a mean time of 2.1 months (range 1-5 months). Results were evaluated clinically and radiologically (intravenous urogram or CT scan). Immediate success was assessed by intraoperative radiologic monitoring, Long-term success was defined as the absence of recurrence of the stenosis after 6 months. Nineteen procedures were successful among the 23 evaluable cases. With a mean follow-up of 16 months (range 6-39 months), the long-term success rate was 52%: 40% in ureteral strictures and 61% in ureteroenteric strictures. Five strictures secondary to cutaneous diversion and six caused by radiation therapy recurred after dilatation. After cutaneous diversion, the failure occurred mostly at the anastomosis and involved the crossed-over ureter, This study shows that high-pressure balloon dilatation of ureteral strictures has a high early success rate and a long-term success rate of 52%, It can therefore be considered as an alternative to open surgery.
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收藏
页码:335 / 340
页数:6
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