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cases developed long-term re-stenosis (12,2 %) that were successfully treated with a new EBD in 8.
Endoscopic management of POM failed in 10 cases (12.7 %) that required ureteral reimplantation.
Five were early failures (4 intraoperative technical problems and 1 double-J stent migration with
severe re-stenosis), and 5 long-term (4 persistent VUR and 1 re-stenosis recurrence).
CONCLUSIONS
EBD has shown to be an effective treatment of POM with few complications and good outcomes at
long-term follow up. Main complication was secondary VUR that could also be treated endoscopi-
cally with a high success rate. In our opinion, EBD may be considered first-line treatment in POM.
11:29–11:32
S23-5 (PP)
ENDOUROLOGICAL TREATMENT OF SECONDARY
OBSTRUCTIVE MEGAURETER
Laura BURGOS LUCENA, Alberto PARENTE HERNÁNDEZ, Rubén ORTIZ
RODRÍGUEZ, Beatriz FERNÁNDEZ BAUTISTA and Jose María ANGULO MADERO
Hospital Gregorio Marañón, Paediatric Urology, Madrid, SPAIN
PURPOSE
To present our experience and long-term results of endoscopic balloon dilatation of secondary
stenosis after vesicoureteral reimplantation.
MATERIAL AND METHODS
Retrospective study of the patients with ureterovesical strictures after reimplantation surgery treated
by high pressure balloon dilatation. Clinical data, renal function, surgical records, dilatation tech-
nique, postsurgery complications and ultrasonographic and isotopic data (pre and post dilatation)
were evaluated.
RESULTS
Five patients were treated in our department: 4 of them had a Cohen procedure, 1 had a Politano-
Leadbetter surgery and 2 of them had ureteral tapering. In all the patients, ultrasound studies
presented progressive ureterohydronephrosis. Diuretic renogram was obstructive with T ½ >
20 minutes that was unilateral in 4 patients and bilateral in the patient with the Politano-Leadbetter
procedure. Three patients presented lumbar pain and febrile urinary tract infection. Endoscopic
treatment was started performing a retrograde pyelography after Cohen catheterization. High pres-
sure balloon dilatation (2.7 Fr) with a nominal profile of 6–9 mm was used in all cases.
Median operative time was 30 (19–75) minutes and hospital stay was 24 hours in all patients except
in the one with bilateral stenosis and febrile urinary tract infection (72 hrs). No intra or postoperative
complications occurred. Postoperative renogram and ultrasound showed a significant improvement
in elimination curves and dilatation (p<0.05) after a median follow-up of 5 years (2–8).
CONCLUSIONS
Endoscopic dilatation of strictures secondary to ureterovesical reimplantation is technically feasible
and allows good long-term results. Given its low complication rate, it should be considered as the
initial treatment of these patients.