Interventional radiology in the treatment of uretero-pelvic-junction

Numerous authors have reported successful results with both antegrade or re trograde endopyelotomy. Both procedures have proved to be efficient in prim ary as in secondary obstructions. Some additional etiological factors, such as crossing vessels high-grade hidronephrosis and poorly functioning kidne y, may decrease the success rate of these minimally invasive techniques. Th e developement of a cutting balloon catheter used under fluoroscopic contro l simplified the retrograde technique. This tecnique proved to be easier to perform than antegrade or retrograde endoscopic incision and did not requi re specialized instrumentation. In our experience 6 patients from 30 to 65 years old (average age 52) with an ureteropelvic - junction obstruction sec ondary to open surgery underwent endopyelotomy with the cutting balloon dev ice. At the three month followup 4 patients had renographic patent ureterop elvic junction and no modifications were seen at one year follow up The ret rograde endopyelotomy under fluoroscopic control seems to offer a rapid and effective treatment of UPJO. It is indicated for all primary and secondary UPJO obstuction apart forpatients with a concomitant renal stone or with h igh-insertion ureteropelvic junction.