Percutaneous incision of stenotic uroenteric anastomaoses with a cutting balloon catheter: Long-term results

PURPOSE: To describe the technique and results of incision of strictures in anastomotic urinary diversions with a commercially available cutting ballo on catheter. MATERIALS AND METHODS: Thirty-seven stenoses were treated in 32 patients. M ost (28 [88%]) of the patients had undergone surgery For bladder cancer 17. 7 months +/- 17.4 (SD) (range, 3-72 months) before incision. Thirteen patie nts had undergone ileal conduit diversion, and nineteen had undergone enter ocystoplasty. All stenoses were shorter than 3 cm. The presence of adjacent ileal loops and/or iliac vessels was assessed with computed tomography bef ore incision. The cutting wire was oriented anteriorly or anterolaterally, and the balloon was inflated with diluted contrast material during the inci sion. A Kaplan-Meier survival curve was constructed to illustrate the succe ss rates over time. RESULTS: No major complications occurred. Twelve (32%) stenoses recurred in nine patients 15 months +/- 10 (range 6-36 months) after stent removal; th e failure rate was 53% (eight of 15 stenoses) for ileal conduits and 18% (f our of 22 stenoses) for enterocystoplasties. Late failure (>12 months) was observed in four patients. The patency of the other 25 stenoses (23 patient s) was checked 25 months +/- 11 after stent removal (range, 5-43 months). T he actuarial patency rate was 77% at 1 year, 68% at 2 years, and 62% at 3 y ears. CONCLUSION: Cutting balloon incision is a safe and simple alternative to su rgery, particularly when the urinary diversion is enterocystoplasty.