RETROGRADE BALLOON DILATATION AS A MINIMALLY INVASIVE TREATMENT FOR URETERAL STRICTURE
Autori:
Dean Markić, Maksim Valenčić, Anton Maričić, Romano Oguić, Stanislav Sotošek, Josip Španjol, Kristian Krpina, Nino Rubinić
Sažetak
Stenoza uretera nije česta patološka promjena u svakodnevnoj urološkoj praksi. Balonska dilatacija jedna je od najmanje invazivnih metoda u liječenju stenoza uretera. Retrospektivno smo analizirali 24 bolesnika sa stenozom uretera liječenih u našoj ustanovi retrogradnom balonskom dilatacijom. U 11 (45,8%) bolesnika radilo se o ijatrogenoj te u po jednoga (4,2%) o kongenitalnoj stenozi, odnosno o stenozama uzrokovanim urogenitalnom tuberkulozom ili retroperitonealnom fibrozom. U 10 (41,6%) bolesnika uzrok stenoze uretera bio je nepoznat. U 12 (50%) bolesnika bio je sužen pelvični dio, u njih 9 (37,5%) lumbalni dio te u preostala 3 (12,5%) terminalni dio uretera. Svim bolesnicima učinjena je balonska dilatacija uretera retrogradnim pristupom, a jedina komplikacija bila je povišena tjelesna temperatura u 4 (16,7%) bolesnika. U 12 (50%) bolesnika s recidivom bilo je nužno otvoreno operacijsko liječenje ili postavljanje ureteralne endoproteze. Zaključujemo da je u bolesnika s kratkom stenozom uretera, prije otvorenoga kirurškoga liječenja, svakako vrijedno učiniti balonsku dilataciju stenoze.
Summary
Ureteral stricture is not a common urologic condition. Balloon dilatation represents one of the least invasive methods for treatment of ureteral strictures. We retrospectively analysed 24 patients with ureteral strictures treated with retrograde balloon dilatation in our department. The etiology of stricture was iatrogenic in 11 (45.8%) patients, post-TBC in one (4.2%), congenital in one (4.2%), retroperitoneal fibrosis in one (4.2%) and unknown in 10 (41.6%) patients. Twelve (50%) patients had a stricture of pelvic, 9 (37.5%) lumbar, and 3 (12.5%) of terminal ureter. In all patients retrograde balloon dilatation has been performed. Only complication related to the procedure was febrility in 4 patients (16.7%). Restrictures were noted in 12 (50%) patients, who consequently have been treated surgically, or had to be stented. Retrograde balloon dilatation, as a safe and relatively effective treatment, is proposed as the first choice in patients with short ureteral strictures.
