PERCUTANEOUS BALLOON CATHETER DILATATION OF BENIGN URETERAL STRICTURES - EFFECT OF MULTIPLE DILATATION PROCEDURES ON LONG-TERM PATENCY

OBJECTIVE. The purpose of this study was to evaluate the long-term eff icacy of multiple percutaneous balloon dilatations of benign ureteral strictures. Percutaneous dilatation of ureteral strictures with a ball oon catheter was done as an alternative to open surgical repair. MATER IAL AND METHODS. Twenty-eight benign ureteral strictures (in 23 patien ts) were dilated. These included 21 postoperative strictures, 18 of wh ich were at ureteroenteric anastomosis, three postradiation strictures , and four strictures of unknown origin. If the stenosis persisted, di latation was repeated (maximum of four dilatations at I-month interval s). Patients were reevaluated with sonography at 1-month intervals aft er stent removal. RESULTS. The procedure was considered a technical su ccess if there was no radiographic evidence of a stricture or if hydro nephrosis improved on the sonographic examination. Clinical success wa s determined by stable or improved renal function. All dilatations wer e technically successful. Fifteen (54%) of the 28 ureters remained pat ent I month after the final dilatation and removal of the stent. Of th ese 15, 12 were patent 2 months after stent removal, and only five wer e free of stenosis at the 9-month follow-up, making overall success 18 %. All five of these ureters were in the subgroup of patients with ure teroenteric strictures. CONCLUSION. Balloon dilatation of ureteral str ictures is technically successful; however, long-term results are poor . Multiple dilatations are of no benefit in maintaining ureteral paten cy.