MP28-09 BALLOON DILATION OF THE URETER: A CONTEMPORARY REVIEW OF OUTCOMES AND COMPLICATIONS

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy II1 Apr 2015MP28-09 BALLOON DILATION OF THE URETER: A CONTEMPORARY REVIEW OF OUTCOMES AND COMPLICATIONS Nicholas Kuntz, Andreas Neisius, Matvey Tsivian Tsivian, Momin Ghaffar, Fernando Cabrera, Ramy Youssef, Michael Ferrandino, Nishant Patel, Roger Sur, Glenn Preminger, and Michael Lipkin Nicholas KuntzNicholas Kuntz More articles by this author , Andreas NeisiusAndreas Neisius More articles by this author , Matvey Tsivian TsivianMatvey Tsivian Tsivian More articles by this author , Momin GhaffarMomin Ghaffar More articles by this author , Fernando CabreraFernando Cabrera More articles by this author , Ramy YoussefRamy Youssef More articles by this author , Michael FerrandinoMichael Ferrandino More articles by this author , Nishant PatelNishant Patel More articles by this author , Roger SurRoger Sur More articles by this author , Glenn PremingerGlenn Preminger More articles by this author , and Michael LipkinMichael Lipkin More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1232AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Ureteroscopy is a well-established treatment for symptomatic ureteral and renal stones. Ureteral balloon dilation may be necessary to allow passage of endoscopic instruments or ureteral access sheaths (UAS). Herein, we assessed the outcomes and complications associated with ureteral balloon dilation during ureteroscopic procedures. METHODS A retrospective review (2000-2012) was performed on patients who received balloon dilation of the ureter prior to endoscopic treatment of upper tract stones. An 18 Fr UromaxTM balloon dilator was used in all cases. Prior ureteral strictures, radiation therapy or urothelial cancer were excluded. The primary outcomes were: stone-free rates, complications, treatment failures and stricture rates. Stone-free was defined as no residual stones at follow-up imaging. Complications were divided into intraoperative and post-operative (Satava and Clavien-Dindo classification). Treatment failure was defined as inability to access the stone despite dilation, requiring a second procedure. Ureteral stricture diagnosis required new onset hydronephrosis on follow-up imaging without evidence of obstructing stone and a confirmatory functional study or endoscopic finding. RESULTS Overall, 151 patients fulfilled study criteria, with a median follow-up of 12 months. The median age was 51, and 65% were male. Multiple stones were seen in 36%, and median maximum stone diameter was 7mm. UAS were employed in almost 80% of cases, and JJ stents were left in 96%. Approximately 50% of balloon dilations were employed secondary to the inability to pass a UAS. There were 8 (5%) intra-operative ureteral perforations. Of these, 7 were managed with a ureteral stent, 1 with a PCN tube, and 4 patients required endoscopic re-treatment (Satava 2b). The overall post-operative complication rate was 7% (11). Notably, of these 11 complications, there are only 4 that are a direct result from balloon dilation. A single ureteral stricture attributed to balloon dilation was identified. The treatment failure rate was 5%, and stone-free rate was 72%, with a predominant utilization of IVP and CT scan at post-op imaging. CONCLUSIONS In this contemporary review, balloon dilation of the ureter prior to endoscopic treatment of stone disease was associated with a high success rate and few complications. The use of ureteral balloon dilation may reduce the need for secondary procedures for patients undergoing ureteroscopy for the treatment of proximal ureteral and intra-renal stones. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e314 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nicholas Kuntz More articles by this author Andreas Neisius More articles by this author Matvey Tsivian Tsivian More articles by this author Momin Ghaffar More articles by this author Fernando Cabrera More articles by this author Ramy Youssef More articles by this author Michael Ferrandino More articles by this author Nishant Patel More articles by this author Roger Sur More articles by this author Glenn Preminger More articles by this author Michael Lipkin More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...