1997 Volume 88 Issue 8 Pages 719-726
(Background) This study investigated the feasibility of retrograde endopyelotomy with the Acucise ureteral cutting balloon device in the managemant of ureteropelvic junction (UPJ) obstruction.
(Methods) Six patients (male: 3, female: 3, age: 6-48) with UPJ obstruction and abdominal pain as the chief complaint, were treated by the Acucise ureteral cutting balloon device (flexible ureteral catheter, 7Fr) under epidural or general anesthesia (for the 6--year-old girl only). After cutting the stenotic area electrically and posteriolaterally using a 3cm cutting wire and dilation by the balloon to a maximum of 24Fr for 10 seconds, a 6/10Fr (for children) or 7/14Fr (for adults) endopyelotomy ureteral catheter was left in situ for 8 weeks after the opeation. After removing the ureteral catheter transurethrally, the results, including the patency of the UPJ, of this procedure were evaluated by intravenous pyelography and the disappearance of the chief complaint, abdominal pain, 12 weeks after removing the ureteral catherer.
(Results) Mean operative time was 47 (25-90) minutes and the hospital stay after the operation was 5.3 (3-14, mediam: 4) days. There was no tranfusion or emergent open operation for uncontrolled bleeding in this series. The results 20 months after the operation: improvement of hydronephrosis was shown in 4 patients (66.7%) on intravenous pyelography and abdominal pain disappeared in all patients.
(Conclusion) UPJ obstruction may be easily and sefely treated by retrograde endopyelotomy with the Acucise ureteral cutting balloon device. The principal potential adventage of this procedure is reduced morbidity compared to that with antegrade or retrograde endopyelotomy by endoscopy.
