PERCUTANEOUS BALLOON CATHETER DILATATION OF BENIGN URETERAL STRICTURES - EFFECT OF MULTIPLE DILATATION PROCEDURES ON LONG-TERM PATENCY

OBJECTIVE. The purpose of this study was to evaluate the long-term efficacy of multiple percutaneous balloon dilatations of benign ureteral strictures. Percutaneous dilatation of ureteral strictures with a balloon catheter was done as an alternative to open surgical repair. MATERIAL AND METHODS. Twenty-eight benign ureteral strictures (in 23 patients) were dilated. These included 21 postoperative strictures, 18 of which were at ureteroenteric anastomosis, three postradiation strictures, and four strictures of unknown origin. If the stenosis persisted, dilatation was repeated (maximum of four dilatations at I-month intervals). Patients were reevaluated with sonography at 1-month intervals after stent removal. RESULTS. The procedure was considered a technical success if there was no radiographic evidence of a stricture or if hydronephrosis improved on the sonographic examination. Clinical success was determined by stable or improved renal function. All dilatations were technically successful. Fifteen (54%) of the 28 ureters remained patent I month after the final dilatation and removal of the stent. Of these 15, 12 were patent 2 months after stent removal, and only five were free of stenosis at the 9-month follow-up, making overall success 18%. All five of these ureters were in the subgroup of patients with ureteroenteric strictures. CONCLUSION. Balloon dilatation of ureteral strictures is technically successful; however, long-term results are poor. Multiple dilatations are of no benefit in maintaining ureteral patency.