title: Management of ureteropelvic junction obstruction with high-pressure balloon dilatation: long-term outcome in 50 children under 18 months of age.
abstract: OBJECTIVE
  To analyze the usefulness of dilatation in the treatment of ureteropelvic junction obstruction (UPJ) in children <18 months of age, including newborns and infants.
  
  
  METHODS
  Patients (n = 50; <18 months of age) were diagnosed using abdominal ultrasound, cystogram, and diuretic renography. Treatment was with endourologic retrograde balloon dilatation under fluoroscopic guidance. The balloons were, in all cases, semicompliant with a profile of 5 mm, 6 mm, or 7 mm. Follow-up was for 42.9 ± 23.2 months (mean ± SD). Double-J stents were inserted postdilatation, the caliber and length depending on the patient's body weight.
  
  
  RESULTS
  Intervention duration was 22 ± 19 minutes. Dilatation was not possible in 5 patients, and pyeloplasty was the alternative treatment. Hospital stay was 24 hours in 44 patients. Analgesic needs were met exclusively by nonsteroidal anti-inflammatory drugs. The double-J stent was withdrawn using cystoscopy and the UPJ was calibrated.Residual stenosis was found in 7 patients. A second dilatation was required in 3 patients 6-18 months after surgery because of the lack of improvement of hydronephrosis. During follow-up, resolution of the hydronephrosis was observed in 45 cases (anterior-posterior diameter of the renal pelvis 7 ± 5 mm). The diuretic renography improved in 45 infants; the shape of the curve being normal in 44 cases and semi-obstructive in 1.
  
  
  CONCLUSIONS
  We believe that high-pressure balloon dilatation could be a valid and safe option in the minimally invasive treatment of UPJ obstruction in infants. The outcome is acceptable with a low complication rate.
authors.affiliation: Department of Paediatric Urology, Gregorio Marañón University Hospital, Madrid, Spain. Electronic address: parente80@hotmail.com.
authors.forename: Alberto
authors.initials: A
authors.lastname: Parente
authors.forename: José-María
authors.initials: JM
authors.lastname: Angulo
authors.forename: Rosa Maria
authors.initials: RM
authors.lastname: Romero
authors.forename: Susana
authors.initials: S
authors.lastname: Rivas
authors.forename: Laura
authors.initials: L
authors.lastname: Burgos
authors.forename: Ana
authors.initials: A
authors.lastname: Tardáguila
mesh_terms: D001835:Body Weight; D002138:Calibration; D004106:Dilatation / Q000379:methods*; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D007223:Infant; D007682:Kidney Pelvis / Q000601:surgery / Q000648:ultrastructure; D008297:Male; D011312:Pressure; D011866:Radioisotope Renography / Q000379:methods; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods; D014517:Ureteral Obstruction / Q000601:surgery*