title: [Treatment of uretero-intestinal and uretero-vesical stenoses with the Acucise balloon catheter].
abstract: OBJECTIVE
  Acucise balloon catheter has been proposed as an alternative to open surgery for the treatment of strictures of the ureteropelvic junction because of its low morbidity and the short hospital stay following the endoscopic procedure. The objective of this study was to evaluate the results of this technique applied to patients developing strictures after surgical reimplantation of the ureterovesical (UV) or uretero-intestinal (UI) junction.
  
  
  METHODS
  Between March 1997 and January 2000, 12 strictures (11 patients) were treated by Acucise balloon catheter via an antegrade and/or retrograde approach with double J stenting for an average of 6 weeks (range: 4 to 12 weeks): 6 uretero-ileal strictures (3 Bricker, 1 uretero-ileoplasty, 1 enterocystoplasty and 1 Kock pouch) and 6 ureterovesical strictures (Lich-Grégoir or Faquin UV reimplantations after gynaecological, vascular or endoscopic surgery). The median postoperative follow-up was 16 months (range: 10 months-36 months). A good result was defined by the absence of recurrence of the stricture evaluated both clinically and radiologically (regression of stasis measured by IVU and/or ultrasonography).
  
  
  RESULTS
  The mean operating time was 70 min and the mean hospital stay was 4.8 days (range: 3 and 14 days). Only one intraoperative complication was observed (migration of the double J stent to the kidney). The operation was successful in 8 patients (75%). The success rate was 83% for ureterovesical strictures and 50% for uretero-ileal strictures. A history of previous irradiation appeared to be a factor of failure.
  
  
  CONCLUSIONS
  The Acucise procedure is a minimally invasive and effective (75% success rate) treatment option for the treatment of postoperative stricture after ureteric reimplantations. In our department, this option is considered to be first-line treatment, as surgical reimplantation is reserved for failures of the endoscopic technique.
authors.affiliation: Service d'Urologie et de la Transplantation, Hôpital Edouard Herriot, Place d'Arsonval, 69437 Lyon.
authors.forename: D
authors.initials: D
authors.lastname: Touiti
authors.forename: A
authors.initials: A
authors.lastname: Gelet
authors.forename: E
authors.initials: E
authors.lastname: Deligne
authors.forename: F H
authors.initials: FH
authors.lastname: Fassi
authors.forename: N
authors.initials: N
authors.lastname: Benrais
authors.forename: X
authors.initials: X
authors.lastname: Martin
authors.forename: J M
authors.initials: JM
authors.lastname: Dubernard
mesh_terms: D000328:Adult; D000368:Aged; D002404:Catheterization / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D014517:Ureteral Obstruction / Q000209:etiology* / Q000628:therapy*; D001743:Urinary Bladder / Q000601:surgery; D014547:Urinary Diversion / Q000009:adverse effects*