الفهرس 
Material and methodsOnly 14 pages are availabe for public view
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Abstract
This work was an attempt to assess the efficacy of the fluoroscopically controlled balloon-cutting catheter (Acucise) for the
treatment of ureteral strictures and pelviureteral junction obstruction
(P.u.J.G.).
Between November 1997 and March 2000, in Benha Faculty of
Medicine, a total of 30 patients (13 males and 17 females) with
pelviureteric junction obstruction and/or ureteral strictures, were included
in this study. Their mean age was 42 years (range 19 - 66). Pain was the
presenting symptom in all the P.u.J.G. and ureteral stricture cases.
Two patients of the P.u.J.G. group were excluded from the current
study as their strictures were inaccessible during operation, where 28
cases were treated using the ACUCISE balloon cutting catheter, (16
P.u.J.G. and 12 ureteral strictures, 8 upper & 4 lower).
Patients with a history of malignancy and irradiation were
excluded. Also those patients with strictures more than 2 em in length,
strictures in the middle 1/3 of the ureter, ureteroenteric strictures, high
insertion of the pelviureteric junction and those in the child age group or
younger were similarly excluded from the study.
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Summary and conclusions
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Each patient was assessed with a full history and physical
examination, laboratory investigations. For each patient an intravenous
urogram and/or a retrograde urogram were obtained. A diuretic renal scan
was done in equivocal cases.
The Acucise R-P, catheter was used to manage pelviureteric
junction obstruction and ureteral strictures. The results were evaluated
after a three-month interval postoperative both symptomatic and
radiological.
A 75% success rate was obtained for strictures in the upper ureter,
66.6% for secondary P.D.J.D., 60% for primary P.D.J.D., and a 50%
success rate for strictures in the lower end of the ureter. The highest
success rate was that of primary ureteral strictures (100%). No major
complications were encountered.
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Summary and conclusions
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CONCLUSION:
Based on the findings in this work, the ACUCISE balloon-cutting
device provides a simple and effective method for performing a
retrograde endoureterotomy or endopyelotomy.
It appears to be superior to antegrade endopyelotorny for treatment
of secondary ureteropelvic junction obstruction because of equivalent or
higher success rates and less degree of invasiveness.
The ACUCISE provided its highest success rates in this study in
those strictures located in the upper ureter, and the lowest in the lower
ureter. where primary ureteral strictures yielding the best results.
A low success rate is anticipated in cases of pujo with severe
hydronephrosis or poor function of the renal unit treated, also when a
waist in the inflated balloon or extravasation are not evident
intraoperatively. .
With better patient selection and proper operative technique, even
higher success rates approaching those of open operative procedures with
the least complications can be achieved.
It is an easy and rapid yet effective procedure that can be performed by almost any urologist. It allows a shorter hospital stay and
better patient tolerance.