Medium-term results of the endourological management with balloon dilatation of the ureteropelvic junction stenosis in infants

• Published in: Actas urologicas españolas Vol. 33; no. 4; pp. 422 - 428
• Main Authors: Parente Hernández, Alberto, Angulo Madero, José M, Romero Ruiz, Rosa M, Rivas Vila, Susana, Laín Fernández, Ana, Fanjul Gómez, María
• Format: Journal Article
• Language: Spanish
• Published: Spain 01-04-2009
• Subjects: Catheterization; Constriction, Pathologic; Female; Humans; Infant; Kidney Pelvis; Male; Retrospective Studies; Time Factors; Ureteral Obstruction - therapy
• ISSN: 0210-4806
• DOI: 10.1016/S0210-4806(09)74169-5

In the last years it has spread minimally invasive therapeutic for the treatment of pyeloureteral junction obstruction in children. Some of them have got poor outcomes in 4-year-old minor children. We show our experience in the retrograde dilatation with balloon of high pressure in infants.
It's a retrospective study of 16 infants treated in our hospital. The average follow-up after the intervention is 27.4 +/- 10.0 months. The diagnostic protocol included abdominal ultrasound, cystogram and diuretic renography. The treatment was realized by endourology retrograde balloon dilatation under fluoroscopy. The balloons were in all the cases semicompliant, with a profile of 5 mm, 6 mm 6 7 mm. After the expansion there was placed stents type double J with profile and length depending on the weight of the patient. To obtain the results, we do ultrasound scans and diuretic renography at least 1 year after the intervention.
The mean duration of the intervention was 36.4 +/- 15.5 minutes. During the intervention, in 2 patients the placement of the stent was not possible. The time of revenue was 48 hours in all the patients except in 1 of them. The analgesic needs were exclusively non steroid antiinflammatorys. The double J stent was withdrawn with cystoscopy. In 3 patients there were postoperatory complications: a migration of the stent, a urinary infection and an urinoma. In 1 patient with worsening of hydronephrosis was needed of pyeloplasty. In the controls the disappearance of the hydronephrosis was observed in all the cases, eliminating likewise the expansion of the renal calyces. The diuretic renography improved in all babies, being the boss of the curve normal in 14 cases and semi obstructively in 2. The mean time of elimination was 9.8 +/- 2.8 minutes.
We think that the balloon dilatation of pyeloureteral junction obstruction is a minimally aggressive technique that is possible to realize in infants with good results and scanty complications.