[Clinical research about balloon dilation before incision for patients with ureteric stricture].

OBJECTIVE

To study the use about balloon dilatation before incision for the patients with ureteric stricture.

METHODS

Sixteen patients with ureteric stricture were included in our study. The cases were reviewed retrospectively with regards to the etiological factor, the site of stricture, symptom and diagnosis. Six patients with ureteric stricture were dilated with balloon before incision using Ho YAG laser. Ten patients with ureteric stricture were dilated with rigid ureteroscope before incision using Ho YAG laser. The double "J" stent was kept for 4-6 weeks after operation. All the patients were followed up by ultrasound, BUN and creatinine. Complete success is defined as symptomatic improvement, resolution of hydronephrosis and absence of ureteric stricture 3 months after removal of the double "J" stent. If the hydronephrosis and ureteric stricture did not deteriorate, and symptom improved after stent removal, it was considered as improvement. Failure is defined as deterioration of hydronephrosis and symptoms upon removal of double "J" stent.

RESULTS

The length of stenosis was from 0.8 to 1.4 cm. Three patients failed to improve after initial dilatation with rigid ureteroscope, but were later successfully dilated using balloon. All the patients who were treated using balloon dilatation were successful. The operative time of balloon dilatation was shorter than that of dilatation by rigid ureteroscope (P < 0.05). However, the cost of balloon dilatation was higher (P < 0.05). The period of follow-up was 3-28 months. None of the patients had any complications. There were 2 cases of recurrent stricture in patients who underwent ureteroscopic dilatation.

CONCLUSIONS

Despite a higher cost, balloon dilatation followed by laser incision for ureteric stricture is safe and effective. This technique may be used for selected patients.