Journal List > Korean J Urol > v.47(8) > 1069954

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Koh, Lee, Kim, and Cho: Endopyelotomy and Endoureterotomy with the Ureteral Cutting Balloon Device (Acucise®)
Original Article
Korean Journal of Urology

Korean Journal of Urology 2006; 47(8): 818-823.

Published online: 31 August 2006

DOI: https://doi.org/10.4111/kju.2006.47.8.818

Endopyelotomy and Endoureterotomy with the Ureteral Cutting Balloon Device (Acucise®)

Jun Sung Koh, Dong Hwan Lee, Doo Bae Kim, Su Yeon Cho

Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Corresponding author (urocsy@yahoo.co.kr)

Received 10 April 2006       Accepted 2 May 2006

Copyright © 2006 The Korean Urological Association

Abstract

Purpose

Endourological management of ureteropelvic junction obstruction (UPJO) has gained increased acceptance with high procedural success rates and low morbidity being reported. It has been suggested that Acucise endopyelotomy should be the procedure of choice for patients with UPJO. The purpose of this study is to determine the efficacy of the Acucise balloon for the treatment of ureteral strictures and UPJO.

Materials and Methods

Between March 2004 and June 2005, 13 consecutive patients (8 primary and 5 secondary cases of UPJO) underwent Acucise endopyelotomy at our institution. The preoperative evaluation included ultrasound and/or intravenous urogram with diuretic renography. The success of the procedure was based on objective radiologic improvement and the subjective resolution of symptoms.

Results

The mean follow-up was 6.77±3.83 months (range: 3-14). The mean operating time was 64.23±34.87 min and the mean hospital stay was 4.15±2.44 days. The objective success rate was 61.5% and the subjective success rate was 69.2%. There were no major complications such as vascular injury requiring transfusion. Yet a small urinoma developed in one patient. Of the 5 objective failures, 3 patients have since successfully undergone open pyeloplasty.

Conclusions

In this small series, Acucise endopyelotomy is a safe and minimally invasive procedure that offered effective first-line treatment for UPJO, although multicenter randomized trials are needed to make a better comparison with the other techniques.

Keywords: Ureter, Ureteral obstruction, Urologic surgical procedures

Figures and Tables

Fig. 1
(A) Guide wire access across the obstructed ureteropelvic junction. (B) Acucise balloon during inflation: note the disappearance of the waist.
kju-47-818-g001
Table 1
Characteristics of the 13 patients
kju-47-818-i001

UPJ: ureteropelvic junction, UTI: urinary tract infection

Table 2
Results of acucise endopyelotomy for the treatment of ureteropelvic junction obstruction and ureteral stricture
kju-47-818-i002

GEA: general endotracheal anesthesia

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