A Comparative Study of Endoscopic Balloon Dilatation and Laparoscopic Ureteral Replantation in the Treatment of Primary Obstructive Megaureter

Q: What was the main goal of comparing EBD with LUR for primary obstructive megaureter (POM)?

To evaluate and compare efficiency and safety of endoscopic balloon dilatation versus laparoscopic ureteral reimplantation in pediatric POM, focusing on outcomes and complications.

Q: How were the pediatric patients selected and what were the key exclusion criteria?

Children with POM treated with EBD or LUR between January 2019 and July 2021 were retrospectively reviewed. Exclusions included ureteropelvic junction obstruction, previous failed ureteral reimplantation, a distal narrowed ureteral segment longer than 3 cm, and follow-up shorter than 6 months.

Q: What differences were observed between the EBD and LUR groups in operative and clinical outcomes?

EBD had shorter operative time, less blood loss, and shorter postoperative hospitalization. LUR had a higher success rate, with no significant baseline differences in demographics, clinical manifestations, or pre-operative renal function.

Q: What conclusion does the study make about the effectiveness of EBD in children with POM?

Although EBD is more non-invasive, it appears less effective for POM overall, and a one-size-fits-all approach may not work. The authors suggest EBD may be more appropriate for certain subtypes and require further studies to define optimal indications.

Jul 10, 2026

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The study compares endoscopic balloon dilatation (EBD) and laparoscopic ureteral reimplantation (LUR) for primary obstructive megaureter (POM) in children, where surgery is often required and LUR is considered the standard approach. A retrospective review included pediatric patients treated between January 2019 and July 2021. EBD showed shorter operative time, less blood loss, and shorter postoperative hospitalization, while LUR achieved a higher success rate. Preliminary results suggest EBD may be less effective overall and may suit specific POM subtypes.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages6

Reading Time15 min

Abstract

Purpose

Methods

Results

Conclusions

Introduction

Materials and Methods

Patients and Data Collection

Surgical Procedures and Post-operation Management

Pediatric Surgery International (2025) 41:219 [https://doi.org/10.1007/s00383-025-061](https://doi.org/10.1007/s00383-025-061)15-6 A comparative study of endoscopic balloon dilatation and laparoscopic ureteral replantation in the treatment of primary obstructive megaureter Yan‑Xi Wang1,2 · Hong‑Song Chen1,2 · Zhi‑Cheng Zhang1,2,3 · Jin Luo1,2,3 · Chong Wang1,2 · Xue‑Yu He1,2,3 · Zhen‑Min Liu1,2,3 · Da‑Wei He1,2,3 · Xing Liu1,2,3 · Guang‑Hui Wei1,2,3 Accepted: 4 July 2025 / Published online: 18 July 2025 © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2025 Abstract Purpose Surgical intervention may be required in some children with primary obstructive megaureter (POM) and laparoscopic ureteral reimplantation (LUR) is regarded as the standard approach. With the recent development of endoscopic technology, endoscopic balloon dilation (EBD) has gained popularity. We sought to describe our initial experience with EBD in treating POM, and to compare efficiency and safety with the LUR. Methods A retrospective chart review was performed on children who underwent EBD or LUR between January 2019 and July 2021. Patient demographics, clinical manifestation and perioperative parameters, complications and primary outcomes were analyzed. Results A total of 6 patients underwent EBD and 13 underwent LUR during the study period. There were no significant differences in the demographics, clinical manifestation and pre-operative renal function between the EBD and the LUR groups. Although the EBD series was associated with shorter operative time (p < 0.001), less blood loss (p < 0.001), and shorter postoperative hospitalization (p < 0.001), patients undergoing LUR had a higher success rate (p < 0.01) . Conclusions Our preliminary results suggested that the EBD, though more non-invasive, seems less effective in the surgical management of POM. The “one size fits all” approach of EBD does not work with POM. Perhaps the EBD is not effective for all children with POM, but for some specific subtypes. Further studies were needed to better clarify the optimal indications of EBD. Keywords Primary obstructive megaureter · Pediatrics · Laparoscopic ureteral reimplantation · Endoscopic balloon dilation · Hydroureteronephrosis * Xing Liu [dr.liux0217@gmail.com](dr.liux0217@gmail.com) 1 Department of Urology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children’s Hospital of Chongqing Medical University, 136 Zhongshan Road, 400014 Chongqing, People’s Republic of China 2 Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, 400014 Chongqing, People’s Republic of China 3 Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, 400014 Chongqing, People’s Republic of China Introduction The management goal of primary obstructive megaureter (POM) includes preservation of renal function, symptomatic resolution and minimal surgical trauma if clinically unavoidable [1] . Ureteral reimplantation was recognized asthe standard treatment for patients in which initial conservative management failed or at high risk of deterioration [2, 3] . Currently, compared to the open approach, laparoscopicureteral reimplantation (LUR) was the preferred option due to its typical advantages of high success rate, less postoperative analgesics, shorter hospitalization and better cosmetic appearance [4, 5] . In the last two decades, advances in endoscopic technology have provided a series of minimally invasive modalities to the armamentarium of urologists [6] . Nowadays, many surgeons consider endoscopic balloon dilation (EBD) asan appealing modality in the treatment of progressive or persistent POM

FAQs

What was the main goal of comparing EBD with LUR for primary obstructive megaureter (POM)?

To evaluate and compare efficiency and safety of endoscopic balloon dilatation versus laparoscopic ureteral reimplantation in pediatric POM, focusing on outcomes and complications.

How were the pediatric patients selected and what were the key exclusion criteria?

Children with POM treated with EBD or LUR between January 2019 and July 2021 were retrospectively reviewed. Exclusions included ureteropelvic junction obstruction, previous failed ureteral reimplantation, a distal narrowed ureteral segment longer than 3 cm, and follow-up shorter than 6 months.

What differences were observed between the EBD and LUR groups in operative and clinical outcomes?

EBD had shorter operative time, less blood loss, and shorter postoperative hospitalization. LUR had a higher success rate, with no significant baseline differences in demographics, clinical manifestations, or pre-operative renal function.

What conclusion does the study make about the effectiveness of EBD in children with POM?

Although EBD is more non-invasive, it appears less effective for POM overall, and a one-size-fits-all approach may not work. The authors suggest EBD may be more appropriate for certain subtypes and require further studies to define optimal indications.

Jul 10, 2026

Upload by Anda