BALLOON DILATATION OF THE PELVIURETERIC JUNCTION IN CHILDREN - EARLY EXPERIENCE AND PITFALLS

Early experience with minimally invasive procedures performed on child ren with pelviureteric junction obstruction is described. Balloon dila tation of the pelviureteric junction was performed in children aged be tween 5 months and 10 years. Ten procedures were performed in nine chi ldren, six for pelviureteric junction obstruction and four for strictu re following surgical pyeloplasty. In none of the cases was a stent in serted following the procedure. In two cases the procedure was perform ed by antegrade approach following nephrostomy and in eight cases by r etrograde approach following cystoscopy. In four cases the procedure w as successful with relief of symptoms and/or improvement in radiologic al appearance, in three cases the radiological appearance was unchange d and in three cases the procedure resulted in complete obstruction of the pelviureteric junction requiring surgical intervention. Two of th e retrograde procedures resulted in vesicoureteric junction obstructio n, one requiring reimplantation and the other nephrectomy. We recommen d the antegrade approach to avoid trauma to the vesicoureteric junctio n, and our results suggest that stenting is necessary to prevent early obstruction.