title: Primary obstructive megaureter: cutting balloon endo-ureterotomy.
abstract: OBJECTIVE
  In this video we will demonstrate endo-ureterotomy using a cutting balloon for vesico-ureteric junction (VUJ) dilatation and stenting of the primary obstructive megaureter.
  
  
  METHODS
  For the technique, a 0.014 inch guide-wire is endoscopically inserted through the VUJ and allowed to curl in the megaureter. A 3 mm atherotome-bladed cutting balloon is inflated with iohexol contrast solution. Under fluoroscopy or cystoscopically, the stenotic VUJ segment is observed to open and post-dilated with a 4 mm simple balloon before JJ stent placement for six weeks.
  
  
  RESULTS
  This video demonstrates the equipment and technique of VUJ endo-ureterotomy using a cutting balloon and stenting of the primary obstructive megaureter.
  
  
  CONCLUSIONS
  Where intervention for the primary obstructive megaureter is indicated, we propose VUJ endo-ureterotomy as the first line treatment.
authors.affiliation: Department of Paediatric Urology, Great Ormond Street Hospital NHS Foundation Trust, London, UK. naima.smeulders@gosh.nhs.uk
authors.forename: Naima
authors.initials: N
authors.lastname: Smeulders
authors.forename: Francisca
authors.initials: F
authors.lastname: Yankovic
authors.forename: Samantha
authors.initials: S
authors.lastname: Chippington
authors.forename: Abraham
authors.initials: A
authors.lastname: Cherian
mesh_terms: D004724:Endoscopy / Q000379:methods*; D006801:Humans; D015607:Stents; D014513:Ureter / Q000002:abnormalities* / Q000473:pathology / Q000601:surgery*; D014517:Ureteral Obstruction / Q000601:surgery*; D001743:Urinary Bladder; D014546:Urinary Catheterization; D013520:Urologic Surgical Procedures / Q000379:methods*
keywords: Balloon dilatation; Endo-ureterotomy; Obstruction; Primary obstructive megaureter; Vesico-ureteric junction