URETEROPELVIC JUNCTION OBSTRUCTION AND URETERAL STRICTURES TREATED BYSIMPLE HIGH-PRESSURE BALLOON DILATION

The long-term results of simple high-pressure balloon dilation in the treatment of ureteropelvic junction obstruction (UPJO) and ureteral st rictures were evaluated, A total of 77 consecutive patients were treat ed: 40 had UPJO and 37 ureteral strictures, The etiology of the obstru ction included congenital UPJO, previous stones, sequelae of endoscopi c and open surgery, radiotherapy, and urinary tract reconstruction, A retrograde ureteroscopic approach was used. Evaluation included clinic al and radiographic examinations and renal scintigraphy with diuretic wash-out. The procedure was repeated in 21 cases. The median follow-up was 29 months. The procedure was considered successful if it left the patient asymptomatic and with improved renographic function and drain age. The overall success rate was 70%, The best results were obtained in strictures secondary to stones, with a success rate of 94%, and in strictures secondary to reconstructive and ureteroscopic surgery, with a success rate of 91%, In congenital UPJO, the results were less enco uraging: in patients with a symptom debut after the age of 18 years, b alloon dilation was successful in 57% of cases; in patients with sympt om debut before the age of 18 years, success was achieved in only 25% of cases. There mere no major complications. It was concluded that sim ple high-pressure balloon dilation is a safe and reasonably effective technique for the management of most ureteral strictures and congenita l UPJO with symptom debut in adult life, Balloon dilation seems to hav e no place in the treatment of primary congenital UPJO in children.