Balloon Dilation of the Ureter: A Contemporary Review of Outcomes and Complications

Kuntz, Nicholas; Neisius, Andreas; Tsivian, Matvey; Ghaffar, Momin; Patel, Nishant; Ferrandino, Michael N.; Sur, Roger L.; Preminger, Glenn M.; Lipkin, Michael

doi:10.1016/j.juro.2015.02.2917

Cited by 53 publications

(28 citation statements)

References 27 publications

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“…HPBD has been well documented in the management of ureteral stricture (Lewis-Russell et al, 2004;Kuntz et al, 2015). The HPBD procedure achieves dilation via radial cracking and expansion of the surrounding scar tissue.…”

Section: Discussionmentioning

confidence: 99%

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High-pressure balloon dilation for male anterior urethral stricture: single-center experience

Wang

et al. 2016

J. Zhejiang Univ. Sci. B

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Abstract:Objectives: We retrospectively reviewed the urethral stricture cases treated in our tertiary center, and assessed the safety and feasibility of the high-pressure balloon dilation (HPBD) technique for anterior urethral stricture. Methods: From January 2009 to December 2012, a total of 31 patients with anterior urethral strictures underwent HPBD at our center, while another 25 cases were treated by direct vision internal urethrotomy (DVIU). Patient demographics, stricture characteristics, surgical techniques, and operative outcomes were assessed and compared between the two groups. The Kaplan-Meier survival analysis was applied to evaluate the stricture-free rate for the two surgical techniques. Results: The operation time was much shorter for the HPBD procedure than for the DVIU ((13.19±2.68) min vs. (18.44±3.29) min, P<0.01). For the HPBD group, the major postoperative complications as urethral bleeding and urinary tract infection (UTI) were less frequently encountered than those in DVIU (urethral bleeding: 2/31 vs. 8/25, P=0.017; UTI: 1/31 vs. 6/25 P=0.037). The Kaplan-Meier survival analysis showed that there was no significant difference in stricture-free rate at 36 months between the two groups (P=0.21, hazard ratio (HR)=0.65, 95% confidence interval (CI): 0.34 to 1.26). However, there was a significantly higher stricture-free survival in the HPBD group at 12 months (P=0.02, HR=0.35, 95% CI: 0.14 to 0.87), which indicated that the stricture recurrence could be delayed by using the HPBD technique. Conclusions: HPBD was effective and safe and it could be considered as an alternative treatment modality for anterior urethral stricture disease.

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Section: Discussionmentioning

confidence: 99%

“…High-pressure balloon dilation (HPBD) is an effective and safe procedure that has been well documented in the management of ureteral stricture (Lewis-Russell et al, 2004;Kuntz et al, 2015). We have applied HPBD in a series of patients with anterior urethral strictures.…”

Section: Introductionmentioning

confidence: 99%

High-pressure balloon dilation for male anterior urethral stricture: single-center experience

Wang

et al. 2016

J. Zhejiang Univ. Sci. B

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“…The main shortcomings of pre‐stenting are the necessity for at least two separate operating sessions as well as JJ stent‐related morbidity; therefore, some authors advise active ureteral dilatation using a semi‐rigid ureteroscope, a balloon dilator or serial coaxial tapered dilators, with increasing size in cases of primary UAS insertion failure . Alternatively, some authors insert the inner UAS dilator prior to the insertion of the whole UAS unit .…”

Section: Resultsmentioning

confidence: 99%

“…Alternatively, some authors insert the inner UAS dilator prior to the insertion of the whole UAS unit . To date, only descriptive studies on active ureteral dilatation are available and nobody has compared the risk of long‐term ureteral damages between active and passive dilatation . In a worldwide questionnaire assessment, only 21% of the responders actively dilated the ureter routinely for URS .…”

Section: Resultsmentioning

confidence: 99%

Systematic review of ureteral access sheaths: facts and myths

et al. 2018

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The aim of the present paper was to review the literature on all available ureteral access sheaths (UASs) with their indications, limitations, risks, advantages and disadvantages in current modern endourological practice. Two authors searched Medline, Scopus, Embase and Web of Science databases to identify studies on UASs published in English. No time period restriction was applied. All original articles reporting outcomes or innovations were included. Additional articles identified through references lists were also included. Case reports, editorials, letters, review articles and meeting abstracts were excluded. A total of 754 abstracts were screened, 176 original articles were assessed for eligibility and 83 articles were included in the review. Based on a low level of evidence, UASs increase irrigation flow during flexible ureteroscopy and decrease intrapelvic pressure and probably infectious complications. Data were controversial and sparse on the impact of UASs on multiple reinsertions and withdrawals of a ureteroscope, stone-free rates, ureteroscope protection or damage, postoperative pain, risk of ureteral strictures, and also on its cost-effectiveness. Studies on the benefit of UASs in paediatrics and in patients with a coagulopathy were inconclusive. In the absence of good randomized data, the true impact of UASs on surgery outcome remains unclear. The present review may contribute to the evidence-based decision-making process at the individual patient level regarding whether or not a UAS should be used.

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“…reviewing outcomes for 151 patients who received balloon dilation for UrS, SFr was 72 %, 4 % had dilation failure, and 2.6 % required retreatment. Over a 12-month mean follow-up, with some individuals followed as long as 45 months, the complication rate was 7 %, with only one patient (<1 %) experiencing a ureteral stricture [13].…”

Section: Ureteral Dilating Balloonsmentioning

confidence: 99%

Disposable devices for RIRS: Where do we stand in 2013? What do we need in the future?

2014

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While rapid advances in technology and knowledge continue, continual improvements are necessary. Disposable equipment needs persistent refinement and possible miniaturization. More efficient fragment retrieval devices are needed. Durability of laser fibers and safety within ureteroscopes needs to be improved. Reducing stent morbidity remains an ongoing challenge. Lastly, costs need to be reduced by the further development of disposable flexible ureteroscopes and in the recyclability of disposable devices to improve availability worldwide.

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Balloon Dilation of the Ureter: A Contemporary Review of Outcomes and Complications

Cited by 53 publications

References 27 publications

High-pressure balloon dilation for male anterior urethral stricture: single-center experience

High-pressure balloon dilation for male anterior urethral stricture: single-center experience

Systematic review of ureteral access sheaths: facts and myths

Disposable devices for RIRS: Where do we stand in 2013? What do we need in the future?

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