Retrograde balloon dilatation as a minimally invasive treatment for ureteral stricture
Dean Markić, Maksim Valenčić, Anton Maričić, Romano Oguić, Stanislav Sotošek, Josip Španjol, Kristian Krpina, Nino Rubinić
Department of Urology, University Hospital Rijeka, Rijeka, Croatia
Ureteral stricture is not a common urologic condition. A variety of surgical techniques can be used as a treatment for patients with ureteral strictures. Balloon dilatation is one of the least invasive methods for the treatment of the ureteral strictures and can be performed in either the antegrade or retrograde approach. We retrospectively analysed 24 patients with ureteral strictures treated with retrograde balloon dilatation from January 1999 to December 2011 in our department. Patients were usually presented with hydronephrosis. The etiology of stricture was unknown in 10 patients (41,7%), iatrogenic (11 pts-45,9%), post TBC (1 pt-4,2%), congenital (1 pt-4,2%) and retroperitoneal fibrosis (1 pt-4,2%). The mean age was 57 years (range 16-87). Stricture was situated in the lumbar region of ureter in 9 patients (37,5%), pelvic region (12 patients-50%) and in the terminal part of ureter in 3 patients (12,5%). In the most patients (22 pts-92%) stricture was 1 cm long or less. In all patients retrograde ballooon dilatation was performed. After the stricture was dilated, internal stent (JJ) was inserted for 4-8 weeks. Patients were followed from 1-10 years. Only complication related to procedure was febrility (4 patients-16,7%). Recidive was noted in 12 patients (50%) and treated by Boari flap (2 pts-8,3%), permanent JJ (3 pts-12,5%), repeat balloon dilatation (1 pt-4,2%), nephrectomy (2 pts-8,3%), intestinal interposition (2 pts-8,3%), pyeloureterostomy in one patient (4,2%) with kidney transplantation and one patient (4,2%) was only followed. Retrograde balloon dilatation is safe and relatively effective treatment modality for treatment of short ureteral stricture.