[Efficacy and safety of percutaneous renal access flexible ureteroscope plus balloon dilatation for patients with complex lower ureterostenosis].

OBJECTIVE

To explore the clinical efficacy and safety of percutaneous renal access anterograde flexible ureteroscope plus retrograde balloon dilation in the treatment of complex lower ureterostenosis.

METHODS

Under ultrasonic guidance, renal calices were successfully punctured for 78 patients with lower ureterostenosis. Then the tract was gradually expanded to 24 F with a metal dilator. Afterward upper ureter was expanded with a flexible ureteroscope sheath. Upon an insertion of guide wire into bladder, a 21 F balloon dilator was retrogradely placed in the narrow segment and maintained for 5 min. Then a D-J stent was antegradely deployed along the guide wire. And the clinical efficacy and safety were followed up.

RESULTS

6 F or 7/12 F D-J stent was successfully placed in 47 patients with unilateral ureterostenosis and 31 with bilateral ureterostenosis. The D-J stent was removed after 3 months. During a follow-up period of 3-9 months, 72 patients had gradually reduced hydronephrosis with an effective rate of 92.31%. Hydronephrosis remained unchanged or aggravated in 6 patients requiring regular replacement of D-J stent.

CONCLUSION

For complex middle or lower ureterostenosis, percutaneous renal access anterograde flexible ureteroscope plus retrograde balloon dilatation can reverse infection, hydronephrosis, renal dysfunction and other complications. And it is safe, effective and mini-invasive.