Email this article Results of primary obstructive megaureter treatment using high-pressure balloon dilatation of ureterovesical junction in children
- Authors: Galuzinskaya A.T.1, Zorkin S.N.1, Petrov E.I.1
-
Affiliations:
- National Medical Research Center for Children's Health, Moscow, Russia
- Section: Articles
- URL: https://pediatria.orscience.ru/2658-6630/article/view/364505
- DOI: https://doi.org/10.26442/26586630.2023.2.202214
- ID: 364505
Cite item
Full Text
Abstract
Abstaract
The aim of the study was to evaluate the age dependence of efficacy and safety in high-pressure balloon dilatation (HPBD) for primary obstructive megaureter (POM) in children under 2 years.
Materials and methods.
From 2020 to 2022, we performed a single-center, unblinded study, with a total of 200 children, treated with high-pressure balloon dilatation for primary obstructive megaureter: 117 boys and 83 girls. Study included patients from 1 month to 2 years. The follow-up period was 1 year.
Results.
In this series the overall treatment effectiveness was 92.5%. In 15 cases treatment was not effective and these children proceeded with ureteral reimplantation. We didn’t achieve positive treatment results in children older than 15 months and our statistical model was not significant for failed cases. Treatment failure we presumed to be due to hard to dilate severe stenosis and extreme length of the stenotic area.
Conclusion.
In our study we found high-pressure balloon dilatation of uretero-vesical junction to be safe and effective method for treatment of primary obstructive megaureter in young children. The overall success rate was 92.5%. We recommend considering high-pressure balloon dilatation as the first line treatment for primary obstructive megaureter in young children. In failure cases we suggest to perform ureteral reimplantation.
Full Text
About the authors
Alexandra T. Galuzinskaya
National Medical Research Center for Children's Health, Moscow, Russia
Author for correspondence.
Email: galuzinskaya.alexandra@gmail.com
ORCID iD: 0000-0003-4663-7114
врач-детский хирург урологического отделения с группами репродуктологии и трансплантации
Russian Federation, 119991, Moscow, Russian Federation, Lomonosovskii prosp., 2 korpus 1Sergey N. Zorkin
National Medical Research Center for Children's Health, Moscow, Russia
Email: zorkin@nczd.ru
ORCID iD: 0000-0002-2731-5008
SPIN-code: 4762-8837
Scopus Author ID: 328047
д.м.н., проф.
начальник Центра детской урологии и андрологии, заведующий урологическим отделением с группами репродуктологии и трансплантации
Russian Federation, 119991, Moscow, Russian Federation, Lomonosovskii prosp., 2 korpus 1Evgenii I. Petrov
National Medical Research Center for Children's Health, Moscow, Russia
Email: petrov@nczd.ru
ORCID iD: 0000-0002-5461-621X
к.м.н. врач по рентгенэндоваскулярной диагностике и лечению рентгеновского отделения с ангиографическим кабинетом
Russian Federation, 119991, Moscow, Russian Federation, Lomonosovskii prosp., 2 korpus 1References
- Хацевич ТН, Михайлов ИО. Эндоскопы: Учебное пособие. Новосибирск: ССГА, 2002; с. 2-11 [Khatsevich TN, Mikhaylov IO. Endoskopy. Uchebnoe posobie. Novosibirsk: SSGA, 2002; р. 2-11 (in Russian)].
- Casey RG, Thornhill JA. Joaquin Maria Albarran Y Dominguez. Microbiologist, histologist, and urologist – a lifetime from orphan in Cuba to Nobel nominee. Int J Urol. 2006;13(9):1159-61.
- Fontenot C, O’Leary JP. Dr. Werner Forssman’s self-experimentation. Am Surg. 1996;62(6):514-5.
- Osther PJ, Geertsen U, Nielsen HV. Ureteropelvic junction obstruction and ureteral strictures treated by simple high-pressure balloon dilation. J Endourol. 1998;12(5):429-31.
- Angulo JM, Arteaga R, Rodriguez Alarcon J, Calvo MJ. Role of retrograde endoscopic dilatation with balloon and derivation using doublepig-tailca the terasaninitial treatment forvesico-ureteral junction stenosis in children. Cir Pediatr. 1998;11(1):15-8.
- Angerri O, Caffaratti J, Garat JM, Villavicencio H. Primary obstructive megaureter: initial experience with endoscopic dilatation. J Endourol. 2007;21(9):999-1004.
- Torino G, Collura G, Mele E, et al. Severe primary obstructive megaureter in the first year of life: preliminary experience with endoscopic balloon dilation. J Endourol. 2012;26(4):325-9.
- Christman MS, Kasturi S, Lambert SM, et al. Endoscopic management and the role of double stenting for primary obstructive megaureters. J Urol. 2012;187(3):1018-22.
- Garcı´a-Aparicio L, Rodo J, Krauel L, et al. High pressure balloon dilation of the ureterovesical junction-first line approach to treat primary obstructive megaureter? J Urol. 2012;187(5):1834-8.
- Bujons A, Saldana L, Caffaratti J, et al. Can endoscopic balloon for primary obstructive megaureter be effective in a long-term follow-up. J Ped Urol. 2015;11(1):37.e1-6.
- Сальников В.Ю., Зоркин С.Н., Губарев В.И., и др. Эндоскопическая баллонная дилатация высокого давления как метод лечения первичного обструктивного мегауретера у детей. Педиатрия. Журнал им. Г.Н. Сперанского. 2016;95(5):48-52 [Sal'nikov VIu, Zorkin SN, Gubarev VI, et al. Endoskopicheskaia ballonnaia dilatatsiia vysokogo davleniia kak metod lecheniia pervichnogo obstruktivnogo megauretera u detei. Pediatriia. Zhurnal im. GN Speranskogo. 2016;95(5):48-52 (in Russian)].
- Сальников В.Ю., Зоркин С.Н., Губарев В.И., и др. Современные аспекты малоинвазивного лечения первичного обструктивного мегауретера у детей. Детская хирургия. 2016;20(3):155-9 [Sal’nikov VYu, Zorkin SN, Gubarev VI, et al. Modern aspects of low-invasive treatment of primary obstructive megaloureter in children. Russian Journal of Pediatric Surgery. 2016;20(3):155-9 (in Russian)].
- Губарев В.И., Зоркин С.Н., Сальников В.Ю., и др. Эффективность баллонной дилатации высокого давления при лечении обструктивных уропатий у детей. Педиатрия им. Г.Н. Сперанского. 2017;96(5):152-6 [Zorkin SN, Salnikov VYu, Gubarev VI, et al. The effectiveness of high pressure balloon dilatation in obstructive uropathy treatment in children. Pediatria n.a. GN Speransky. 2017;96(5):152-6 (in Russian)].
- Осипов И.Б., Лебедев Д.А., Комиссаров М.И., и др. Баллонирование уретеровезикального сегмента при обструктивном мегауретере у детей. Российский вестник детской хирургии, анестезиологии и реаниматологии. 2015;S:110 [Osipov IB, Lebedev DA, Komissarov MI, et al. Ballonirovaniie ureterovezikal'nogo segmenta pri obstruktivnom megauretere u detei. Rossiiskii vestnik detskoi khirurgii, anesteziologii i reanimatologii. 2015;S:110 (in Russian)].
- Chiarenza SF, Bleve C, Zolpi E, et al. Endoscopic balloon dilatation of primary obstructive megaureter: method standardization and predictive prognostic factors. Pediatr Med Chir. 2019;41(2).
- Kassite I, Petel MR, Chaussy Y, et al. High Pressure Balloon Dilatation of Primary Obstructive Megaureter in Children: A Multicenter Study. Front Pediatr. 2018;6:329.
- Li S, Tang F, Dai S, et al. Balloon dilatation for lower urethral obstruction in children. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2006;20(3):238-40.
- Destro F, Selvaggio G, Marinoni F, et al. High-pressure balloon dilatation in children: our results in 30 patients with POM and the implications of the cystoscopic evaluation. Pediatr Med Chir. 2020;42(1).
- Галузинская А.Т., Зоркин С.Н. Эффективность баллонной дилатации высокого давления при лечении детей с первичным обструктивным мегауретером. Российский педиатрический журнал. 2020;23(6) [Galuzinskaia AT, Zorkin SN. Effektivnost' ballonnoi dilatatsii vysokogo davleniia pri lechenii detei s pervichnym obstruktivnym megaureterom. Rossiiskii pediatricheskii zhurnal. 2020;23(6) (in Russian)].
Supplementary files
