Balloon Dilation of Edematous Ureteral Segment in Percutaneous Ureterolithotripsy for Long-Term Impacted Calculi

For ureteral calculi above the iliac vessels that have paused in the same place longer than 3 months, percutaneous removal is occasionally difficult, primarily because of pathological reactions of the ureteral mucosa brought about by chronic irritation by the calculi. In these cases of impacted upper- or mid-ureteral calculi, a working space around the calculus was created by inflating a 5F or 7F Grüntzig-type balloon dilation catheter, which facilitated access to the calculus and permitted more irrigant flow. With this technique, the success rate in 22 consecutive patients was 100% compared with 89% in 28 previous patients. The postoperative excretory urogram and CT scan confirmed that balloon dilation performed over a period of 2 minutes causes no significant side effects on the proximal ureteral segment.