Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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Retrograde balloon dilation as a therapeutic option for post-gynecologic surgery ureteral stricture followed by ureteroureterostomy: a comparative study regarding stricture length

  • Lim, Geon Woo (Department of Urology, CHA Bundang Medical Center, CHA University School of Medicine) ;
  • Yu, Young Dong (Department of Urology, CHA Bundang Medical Center, CHA University School of Medicine) ;
  • Choi, Kyung Hwa (Department of Urology, CHA Bundang Medical Center, CHA University School of Medicine) ;
  • Rhee, Seung Ryeol (Department of Urology, CHA Bundang Medical Center, CHA University School of Medicine) ;
  • Park, Dong Soo (Department of Urology, CHA Bundang Medical Center, CHA University School of Medicine) ;
  • Hong, Young Kwon (Department of Urology, CHA Bundang Medical Center, CHA University School of Medicine)
  • Received : 2018.09.13
  • Accepted : 2018.10.16
  • Published : 2018.12.31
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Abstract

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.

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