Korean J Urol.  2006 Aug;47(8):818-823. 10.4111/kju.2006.47.8.818.

Endopyelotomy and Endoureterotomy with the Ureteral Cutting Balloon Device (Acucise(R))

• Koh JS
• Lee DH
• Kim DB
• Cho SY

• KMID: 2294108
• DOI: http://doi.org/10.4111/kju.2006.47.8.818

Abstract

PURPOSE: Endourological management of ureteropelvic junction obstruction (UPJO) has gained increased acceptance with high procedural success rates and low morbidity being reported. It has been suggested that Acucise endopyelotomy should be the procedure of choice for patients with UPJO. The purpose of this study is to determine the efficacy of the Acucise balloon for the treatment of ureteral strictures and UPJO.
MATERIALS AND METHODS
Between March 2004 and June 2005, 13 consecutive patients (8 primary and 5 secondary cases of UPJO) underwent Acucise endopyelotomy at our institution. The preoperative evaluation included ultrasound and/or intravenous urogram with diuretic renography. The success of the procedure was based on objective radiologic improvement and the subjective resolution of symptoms.
RESULTS
The mean follow-up was 6.77+/-3.83 months (range: 3-14). The mean operating time was 64.23+/-34.87 min and the mean hospital stay was 4.15+/-2.44 days. The objective success rate was 61.5% and the subjective success rate was 69.2%. There were no major complications such as vascular injury requiring transfusion. Yet a small urinoma developed in one patient. Of the 5 objective failures, 3 patients have since successfully undergone open pyeloplasty.
CONCLUSIONS
In this small series, Acucise endopyelotomy is a safe and minimally invasive procedure that offered effective first-line treatment for UPJO, although multicenter randomized trials are needed to make a better comparison with the other techniques.

Keyword

Ureter; Ureteral obstruction; Urologic surgical procedures

MeSH Terms

Constriction, Pathologic
Follow-Up Studies
Humans
Length of Stay
Radioisotope Renography
Ultrasonography
Ureter*
Ureteral Obstruction
Urinoma
Urologic Surgical Procedures
Vascular System Injuries

Figure

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  Fig. 1 (A) Guide wire access across the obstructed ureteropelvic junction. (B) Acucise balloon during inflation: note the disappearance of the waist.

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