Results of primary obstructive megaureter treatment using high-pressure balloon dilatation of ureterovesical junction in children

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Abstract

Aim. 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 HPBD for POM: 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 HPBD 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 HPBD as the first line treatment for POM in young children. In failure cases we suggest to perform ureteral reimplantation.

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About the authors

Alexandra T. Galuzinskaya

National Medical Research Center for Children's Health

Author for correspondence.
Email: galuzinskaya.alexandra@gmail.com
ORCID iD: 0000-0003-4663-7114

Pediatric Surgeon

Russian Federation, Moscow

Sergey N. Zorkin

National Medical Research Center for Children's Health

Email: galuzinskaya.alexandra@gmail.com
ORCID iD: 0000-0002-2731-5008

Dr. Sci. (Med.), Prof.

Russian Federation, Moscow

Evgenii I. Petrov

National Medical Research Center for Children's Health

Email: galuzinskaya.alexandra@gmail.com
ORCID iD: 0000-0002-5461-621X

Cand. Sci. (Med.)

Russian Federation, Moscow

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Supplementary files

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2. Fig. 1. Balloon catheter in the obstruction area.

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3. Fig. 2. Analysis of the variable "Age (months)" versus the variable "Result".

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4. Fig. 3. ROC-curve characterizing relationship of the probability of the variable "Result" with the variable "Age (months)".

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5. Fig. 4. Analysis of the sensitivity and specificity of the model depending on the threshold values of the variable "Age (months)".

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