Simple Retrograde Balloon Dilation for the Treatment of Ureteral Strictures: an Etiology-based Analysis

Byun, Seok Soo; Kim, Jeong Hyun; Jeong, Seong Jin; Lee, Kyeong Cheol; Oh, Seung June; Kim, Si Whang; Kim, Hyeon Hoe

Abstract

PURPOSE
The results of a simple retrograde balloon dilation for treating ureteral strictures was analyzed in order to evaluate the efficacy of this procedure and the factors affecting the success rate. MATERIALS AND MTHODS: A prospective study was performed on 43 ureteral strictures (22 malignant, 21 benign) from 37 patients, who were treated with retrograde balloon dilation from October 1997 to May 1999. After the stricture segments were dilated, ureteral stents were indwelled uniformly for 3 weeks. The strictures were followed up radiographically at 1, 3, 6, 12 and 24 months after treatment. The success was defined by a symptomatic and radiographic improvement. The follow-up period ranged from 3 to 43 months (mean 21 months). The prognostic factors affecting the success rate were analyzed.
RESULTS
The success rate of the benign strictures at 12 months was much higher than that of malignant strictures (60% vs, 15%, p=0.0019). Although 48% of the patients with strictures shorter than 2cm were successful after 12 months, only 9% of those with strictures longer than 2cm were successful (p=0.0124). Other prognostic factors such as sex, age, location, presence of immediate success and the grade of hydronephrosis were has little effect on the success rate. Multivariate analysis revealed that etiology was the only significant prognostic factor affecting the final outcome (p=0.0371), and that stricture length was the only significant prognostic factor in the benign cases (p=0.0375).
CONCLUSIONS
Considering its minimal invasiveness, a simple retrograde balloon dilation appears to be a reasonably effective treatment modality for a benign ureteral stricture with a short segment (2cm).