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CONGRESS OF THE ESPU
10:19–10:22
S15-2 (PP)
ENDOSCOPIC BALLOON DILATATION IN PRIMARY
OBSTRUCTIVE MEGAURETER IN INFANTS: LONG-TERM
RESULTS
Isabel CASAL BELOY, Miriam GARCÍA GONZÁLEZ, Ivan SOMOZAARGIBAY and
Teresa DARGALLO CARBONELL
Children's Hospital "Teresa Herrera-Materno Infantil", A Coruña, Pediatric Surgery. Urology Division., A Coruña, SPAIN
INTRODUCTION
The endoscopic balloon dilation is a new minimal invasive alternative for the treatment of Primary
Obstructive Megaureter in infants. This is an effective procedure in short-term follow-up but few
studies have shown its long-term efficacy. The aim of this study is to evaluate the long-term results
of ballon dilation.
MATERIAL AND METHODS
We performed a retrospective review of patients treated with balloon dilation. The indications for
surgery were: worsening of the hydronephrosis, renal function impairment and recurrent urinary
tract infections. All patients were followed 6 months after endoscopic procedure with ultrasonogra-
phy, MAG-3 renogram and voiding cystouretrography. Annual ultrasound was performed until now.
RESULTS
We treated 13 patients, (median age 9 months, range 2 to 24). 10 patients had prenatal diagnoses
of hydronephrosis and in 3 the diagnoses was made after a urinary tract infection. No intraop-
erative complications were observed. 1 double-J stent was replaced after endoscopic procedure
for malpositioning. 4 patients developed an urinary tract infection after surgery. All patients had
non-obstructive MAG-3 diuretic renogram 6 months after surgery. The mean washout on the reno-
gram and the ultrasound pelvic diameter showed pre and postoperative statistical differences. All
patients maintained their results without recurrence in the long-term. The median of follow-up was
10.3 years, (Range: 4.7 to 12.2).
Outcomes
Preoperative
6 months after surgery P-value(Wilcoxon test)
Median distal ureter diameter (mm) 15 (range: 7-22)
4 (range: 3-9)
P < 0.001
Median pelvis diameter (mm)
20 (range: 13-25)
11 (range: 3-15)
P < 0.001
Median DRF (%) MAG-3 renogram 49.7 (range: 29-58)
51 (range: 43-56)
P = 0.249
T ½ (minutes)
MAG-3 renogram
73 (range: 25-150)
5.5 (range: 5-20)
P < 0.001
CONCLUSIONS
Balloon dilation can be an effective procedure for the treatment of Primary Obstructive Megaureter
in long-term follow-up. More studies are needed to demonstrate these results.