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3 . 2022

The use of balloon cardiac catheters for vesicoureteral segment obstruction in pediatric urology

Abstract

Aim. To establish the possibility of using balloon catheters intended to cardio-thoracic surgery for the treatment of vesicoureteral junction obstruction with high-pressure balloon dilatation (HPBD) in children.

Material and methods. Between 2019 and 2021 a total of 51 children with primary obstructive megaureter underwent HPBD. 27 boys and 24 girls were included in the study. The mean age by the time of surgery in both groups was 19 months. The follow-up period for all patients was 1 year. According to data analysis patients were divided in two groups by age: from 1 month to 1 year and from 1 year to 4 years.

Results. In our study we found the following treatment effectiveness criteria: the length of the stenotic area of the ureter, the diameter of the stenosis and area of stenosis. The area of stenosis was determined during the HPBD procedure based on targeted retrograde pyelography. The overall effectiveness of primary obstructive megaureter treatment using HPBD was 84%. This technique has shown a 93% efficiency rate in the first age group (from 1 month to 1 year) and 75% – in the second (from 1 year to 4 years). We found that all positive results were obtained when the length of the stenotic area was lower than 1.8 mm, diameter of the stenosis was more than 0.6 mm, and the stenosis area was less than 96.6%. HPBD failed in cases of 99% area of stenosis and more. 

Conclusion. The use of balloon catheters is applicable as a transluminal method for the treatment of obstructive megaureter in children of a younger age group. This technique is more effective combined with high-frequency targeted pyelography for assessment of stenosis characteristics. It allows to determine both indications for HPBD use and increases its effectiveness. 

Keywords:Balloon catheter; ureter obstruction; balloon dilatation; megaureter

Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Zorkin S.N., Galuzinskaya A.T., Petrov E.I., Filinov I.V. The use of balloon cardiac catheters for vesicoureteral segment obstruction in pediatric urology. Clinical and Experimental Surgery. Petrovsky Journal. 2022; 10 (3): 108–13. DOI: https://doi.org/10.33029/2308-1198-2022-10-3-108-113  (in Russian)

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CHIEF EDITOR
CHIEF EDITOR
Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)
Вскрытие
Medicine today

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