Background To evaluate the success rate of balloon dilation and the factors possibly influencing the outcomes of balloon dilation for the ureteric strictured portion of ureteroureterostomy (UUS) site in patients with post-gynecologic surgeries.
Methods A single institution data base was screened for the patients who received balloon dilation for a treatment of ureteral stricture diagnosed after gynecologic surgery. Overall 114 patients underwent primary intra-operative UUS due to ureteral injury during gynecologic surgery. Among them, 102 patients received balloon dilation, and their medical records were retrospectively reviewed. Success of balloon dilation was defined as the condition that requires no further clinical interventions after 6 months from balloon dilation.
Results The ureter injury rate of women treated with open radical abdominal hysterectomy was highest (32 cases, 31.4%). 60 patients (60.8%) showed successful outcomes regarding dilation. All patients underwent technically successful dilation with a full expansion of balloon during the procedure, but 40 patients (39.2%) were clinically unsuccessful as they showed a recurrence of ureteral stricture on the previous balloon dilation site after the first dilation procedure. Univariate logistic regression analyses showed that stricture length >2 cm was a significant predictor of successful dilation (odds ratio, 0.751; 95% confidence interval, 0.634-0.901; p-value, 0.030), but it failed to achieve independent predictor status in multivariate analysis.
Conclusion Balloon dilation can an effective alternative treatment option for strictured portion of the primary UUS in post-gynecologic surgery patients when its length is <2 cm.
Citations
Citations to this article as recorded by
Mechanical characteristics of the ureter and clinical implications Sorcha O’Meara, Eoghan M. Cunnane, Stefanie M. Croghan, Connor V. Cunnane, Michael T. Walsh, Fergal J. O’Brien, Niall F. Davis Nature Reviews Urology.2024; 21(4): 197. CrossRef
Analysis of the Efficacy and Risk Factors for Failure of Balloon Dilation for Benign Ureteral Stricture Bing Wang, Wenzhi Gao, Kunlin Yang, Honglei Liu, Yangjun Han, Mingxin Diao, Chao Zuo, Minghua Zhang, Yingzhi Diao, Zhihua Li, Xinfei Li, Gang Wang, Peng Zhang, Chunji Wang, Chunjuan Xiao, Chen Huang, Yaming Gu, Xuesong Li Journal of Clinical Medicine.2023; 12(4): 1655. CrossRef
Left-sided flap transposition of the appendix for urethroplasty in oncourology A. K. Nosov, D. I. Rumyantseva, E. M. Mamizhev, P. A. Lushina, N. A. Shchekuteev, M. V. Berkut Cancer Urology.2022; 18(1): 127. CrossRef
Nonsurgical management of four cases of the parasagittal epidural hematoma were experienced. Patients were mildly symptomatic or minimal neurological disturbances on admission. Patients were treated conservatively because of stable neurologic sign. All patients had who diastatic fracture and / or suture have become a complete neurological recovery with satisfactory absorption of EDH over a period of 5 to 12 weeks.