BALLOON CATHETER DILATATION IN THE TREATMENT OF URETERAL AND URETEROENTERIC STRICTURE

Balloon catheter dilatation is a low-cost alternative to open surgery in patients with ureteral strictures, leading to low morbidity and sho rt hospitalization. The goal of this study was to evaluate the results of this technique in patients with inflammatory ureteral strictures o r ureteroenteric strictures after radical cystectomy. Twenty-five uret eral strictures in 20 (15 male, 5 female) patients were consecutively treated by high-pressure balloon dilatation: 14 cases of ureteroenteri c stricture (9 after ileal cutaneous diversion, and 5 after orthotopic enterocystoplasty) and 11 of ureteral stricture from various inflamma tory causes (tuberculosis, iatrogenic injury, radiation therapy, paras itosis), Dilatation was performed by an antegrade (ureteroenteric stri ctures) or retrograde (inflammatory strictures) approach using a ballo on 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 sc an). Immediate success was assessed by intraoperative radiologic monit oring, Long-term success was defined as the absence of recurrence of t he 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 strictur es 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 show s that high-pressure balloon dilatation of ureteral strictures has a h igh early success rate and a long-term success rate of 52%, It can the refore be considered as an alternative to open surgery.