RESUMO
OBJECTIVES: Although the results of endopyelotomy for ureteropelvic junction (UPJ) stenosis are well known, our objective was to study the specific complications of treatment of UPJ stenoses by Acucise balloon. MATERIAL AND METHODS: The specific complications of 50 patients (40 women, 10 men) treated consecutively by Acucise balloon endopyelotomy for UPJ stenosis from January 1994 to February 1999 were reviewed. The mean age was 47 years (range: 19-84 years). Thirty-five stenoses (70%) were primary. A polar pedicle was diagnosed by preoperative CT angiography in 5 cases. The endopyelotomy technique was that described by Chandhokf except in 3 cases in which section with strict external lateral orientation was performed. RESULTS: Mean operating time and mean length of hospital stay were 70 min (range: 35-180 min) and 5.4 days (range: 2-27 days), respectively. Six (12%) technical incidents were observed intraoperatively (3 cases of rupture of balloon) and 7 (14%) haemorrhagic incidents were observed perioperatively (5 polar pedicles). There were no conversions to open surgery. There were 4 (8%) major perioperative complications, all haemorrhagic, which required 2 radiological embolizations and one lumbotomy. Only these patients required transfusion (3.25 units/patient). Fourteen urinary tract infections were observed, including 2 cases of pyelonephritis (4%) and one case of septicaemia (2%). Nine patients experienced severe discomfort due to the double J stent. With a mean follow-up of 47 months, the overall success rate was 74%, not influenced by the development of a complication. Seven (58%) of the 12 patients with failure of endopyelotomy had a lower pole pedicle. CONCLUSION: Acucise endopyelotomy is a simple and effective technique. However, rigorous indications and technique are essential due to the possibility of haemorrhagic complications, often related to a lower pole vessel.
