Retrograde Balloon Dilatation for Pelviureteric Junction Obstruction

McClinton, Samuel; Steyn, J. H.; Hussey, J.

doi:10.1111/j.1464-410x.1993.tb15908.x

Cited by 55 publications

(16 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The evidence regarding benefit from stent insertion is sparse and contradictory [5]. Double-J stent insertion is commonly performed when balloon disruption of the pelviureteric junction is performed in adults [3], but there are no controlled trials to suggest that stent insertion is necessary for the success of the procedure. Results of animal experiments suggest stenting is not required [9].…”

Section: Discussionmentioning

confidence: 99%

Balloon dilatation of the pelviureteric junction in children: early experience and pitfalls

Wilkinson

Azmy

1996

Pediatr Radiol

View full text Add to dashboard Cite

Early experience with minimally invasive procedures performed on children with pelviureteric junction obstruction is described. Balloon dilatation of the pelviureteric junction was performed in children aged between 5 months and 10 years. Ten procedures were performed in nine children, six for pelviureteric junction obstruction and four for stricture following surgical pyeloplasty. In none of the cases was a stent inserted following the procedure. In two cases the procedure was performed by antegrade approach following nephrostomy and in eight cases by retrograde approach following cystoscopy. In four cases the procedure was successful with relief of symptoms and/or improvement in radiological appearance, in three cases the radiological appearance was unchanged and in three cases the procedure resulted in complete obstruction of the pelviureteric junction requiring surgical intervention. Two of the retrograde procedures resulted in vesicoureteric junction obstruction, one requiring reimplantation and the other nephrectomy. We recommend the antegrade approach to avoid trauma to the vesicoureteric junction, and our results suggest that stenting is necessary to prevent early obstruction.

show abstract

Section: Discussionmentioning

confidence: 99%

Balloon dilatation of the pelviureteric junction in children: early experience and pitfalls

Wilkinson

Azmy

1996

Pediatr Radiol

View full text Add to dashboard Cite

show abstract

“…The long-term follow-up for the entire group of 33 children averaged 30 months and In all patients a standard dismembered pyeloplasty was performed [10]. A stent (5-Fr feeding tube) was left across the anastomosis and an 8-Fr nephrostomy tube was used to drain the kidney.…”

Section: Methodsmentioning

confidence: 99%

Long-term outcome of kidneys with initially poor drainage or no drainage following pyeloplasty

Miyamoto

Mesrobian

1996

World J Urol

View full text Add to dashboard Cite

Pyeloplasty for congenital ureteropelvic junction (UPJ) obstruction enjoys a 90-95% success rate. Although treatment of the failed pyeloplasty has been addressed in the literature, management of the poorly draining or nondraining renal unit in the immediate postoperative period has not received any attention. For this purpose the medical records of 33 consecutive children (37 renal units) treated by dismembered pyeloplasty between 1986 and 1992 were reviewed. All of our pyeloplasties were stented and urine was diverted via a nephrostomy tube. All patients underwent a nephrostogram following stent removal 1 week postoperatively. These studies showed poor drainage, or no, across the newly reconstructed anastomosis in 7 of 37 renal units (19%). The ages of these 4 boys and 3 girls at the time of pyeloplasty ranged between 7 weeks and 5 years (mean 22 months). In four patients, good drainage occurred without intervention by 2-4 weeks postoperation. In two patients, percutaneous balloon dilation of the anastomosis via the intraoperatively placed nephrostomy tube was required at 3 and 6 weeks, respectively. The remaining patient failed percutaneous dilation, necessitating a ureterocalycostomy at 9 weeks following pyeloplasty. The long-term follow-up for the entire group of 33 children averaged 30 months and consisted of radionuclide diuresis renography in 84% of cases or intravenous pyelography in the remainder. All patients had excellent long-term outcomes as assessed by comparison of the postoperative studies with the baseline studies obtained preoperatively. Our results show that kidneys with initially poor drainage, or even no drainage, across the newly reconstructed anastomosis following pyeloplasty can be salvaged with an excellent long-term outcome comparable with that of the group with initially good drainage. In addition, intervention was necessary in only 43% of renal units with initial compromise and was facilitated by the intraoperatively placed nephrostomy tube. We recommend that percutaneous dilation be done at between 4 and 6 weeks postpyeloplasty, as the waiting period was long enough to allow for spontaneous improvement without precluding a successful outcome if drainage failed to occur. Ureterocalycostomy was rarely necessary.

show abstract

“…spiral CT or endoluminal ultrasonography. Although Hanna et al have provided theoretical support for the Complications concept of endopyelotomy, in that the PUJ (across which they showed the conduction of peristaltic waves) is The only reported complications following the use of this technique are urinoma in one patient [18] and septipreserved [43], it is interesting that Hendren et al have shown that peristalsis across a dismembered PUJ usually caemia (despite antibiotic prophylaxis) in another [19].…”

Section: Balloon Dilatationmentioning

confidence: 99%

Treatment options for pelvi‐ureteric junction obstruction: implications for practice and training

Eden

1997

British Journal of Urology

View full text Add to dashboard Cite

Retrograde Balloon Dilatation for Pelviureteric Junction Obstruction

Cited by 55 publications

References 5 publications

Balloon dilatation of the pelviureteric junction in children: early experience and pitfalls

Balloon dilatation of the pelviureteric junction in children: early experience and pitfalls

Long-term outcome of kidneys with initially poor drainage or no drainage following pyeloplasty

Treatment options for pelvi‐ureteric junction obstruction: implications for practice and training

Contact Info

Product

Resources

About