Suihko Anna, Ripatti Liisi, Pakkasjärvi Niklas
Department of Pediatric Surgery, Turku University Hospital, University of Turku, Turku, Finland.
Department of Surgery, University of Turku, Vaasa Central Hospital, Vaasa, Finland.
Urol Res Pract. 2025 Jun 4;51(2):70-76. doi: 10.5152/tud.2025.24045.
Objective: The aim was to evaluate the efficacy of high-pressure balloon dilatation (HPBD) for primary obstructive megaureter (POM) treatment in infants. Methods: The authors retrospectively reviewed medical records of 5 infants diagnosed with symptomatic or progressive POM and treated with HPBD between 2015 and 2022 in one hospital, analyzing changes in ureteral and anteroposterior pelvic diameters, Society for Fetal Urology grading, parenchymal thickness, differential renal function, complications, and subsequent surgical needs. Results: High-pressure balloon dilatation was performed on 5 patients, median age 5 months. No statistically significant changes were detected in ureteral diameter (median 11.0-7.0 mm, P = .125), anteroposterior diameters (median 21.5-18 mm, P= .255), parenchymal thickness (median 5.0-5.0 mm, P = .317), or differential renal function post-procedure. Follow-up was median 34 months. Three patients showed improvement in obstructive renogram findings. Complications were primarily related to guidewire insertion and double-J stent placement. Two patients, both younger than 6 months, required open ureteral reimplantation. Conclusion: High-pressure balloon dilatation serves as a minimally invasive approach for POM but is not universally effective, with a high complication rate and 40% of infants needing open surgery post HPBD.
评估高压球囊扩张术（HPBD）治疗婴儿原发性梗阻性巨输尿管（POM）的疗效。方法：作者回顾性分析了2015年至2022年期间在一家医院接受HPBD治疗的5例有症状或病情进展的POM婴儿的病历，分析输尿管及肾盂前后径、胎儿泌尿外科学会分级、实质厚度、分肾功能、并发症及后续手术需求的变化。结果：对5例患者进行了高压球囊扩张术，中位年龄5个月。术后输尿管直径（中位值11.0 - 7.0 mm，P = 0.125）、前后径（中位值21.5 - 18 mm，P = 0.255）、实质厚度（中位值5.0 - 5.0 mm，P = 0.317）或分肾功能均未发现有统计学意义的变化。中位随访时间为34个月。3例患者梗阻性肾图结果有所改善。并发症主要与导丝插入和双J支架置入有关。2例年龄小于6个月的患者需要行开放式输尿管再植术。结论：高压球囊扩张术是治疗POM的一种微创方法，但并非普遍有效，并发症发生率高，40%的婴儿在HPBD术后需要接受开放手术。
