[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-56208-en":3,"doc-seo-56208-105":29,"detail-sidebar-cat-0-en-105":82},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":4,"is_deleted":4,"is_public":20,"is_downloadable":20,"audit_status":20,"page_count":21,"language":22,"language_code":23,"site_id":24,"html_lang":23,"table_of_contents":25,"faqs":26,"seo_title":13,"seo_description":14,"update_tm":27,"read_time":28},56208,7971461740909,"Levi","https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d",7,"Healthcare","Risk and protective factors for secondary procedures after endoscopic dilatation of primary obstructive megaureters","High-pressure balloon dilatation (HPBD) of the ureterovesical junction with double-J stenting is a minimally invasive alternative to ureteral reimplantation for primary obstructive megaureter (POM). A prospective single-institution study evaluated patients treated between 2007 and 2021 and applied multivariate logistic regression to determine predictors of secondary procedures after HPBD failure. Progressive ureterohydronephrosis and early double-J stent removal increased reintervention risk, while longer catheter maintenance lowered it. A 55-day optimal cut-off supported removing the stent after at least 2 months.","World Journal of Urology (2024) 42:463  \n[https://doi.org/10.1007/s00345-024-05181-0](https://doi.org/10.1007/s00345-024-05181-0)  \nRisk and protective factors for secondary procedures after endoscopic dilatation of primary obstructive megaureters  \nSonia Pérez‑Bertólez1 · Oriol Martín‑Solé1 · Isabel Casal‑Beloy1 · Mar Carbonell1 · Paula Salcedo1 · Blanca Capdevila1 · Luis García‑Aparicio1  \nReceived: 3 May 2024 / Accepted: 15 July 2024 / Published online: 1 August 2024  \n© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024  \nAbstract  \nPurpose High-pressure balloon dilatation (HPBD) of the ureterovesical junction with double-J stenting is a minimally invasive alternative to ureteral reimplantation or cutaneous ureterostomy for first-line surgical treatment of primary obstructive megaureter (POM). The aim of our study was to identify the risk factors associated with the need for secondary procedures due to HPBD failure.  \nMethods Prospective data were collected from patients who underwent HPBD for POM between 2007 and 2021 at a single institution. The collected data included patient demographics, diagnostic modalities, surgical details, results, and follow-up. Multivariate logistic regression analysis was performed.  \nResults Fifty-five ureters underwent HPBD for POM in 50 children, with a median age of 6.4 months (IQR: 4.5–13.8) . Nineteen patients (37.25%) underwent secondary ureteric reimplantation, with a median of 9.8 months after primary HBPD (95% CI 6.2–9.9) . The median follow-up was 29.4 months (IQR: 17.4–71) . Independent risk factors for redo-surgery in a multivariate logistic regression model were: progressive ureterohydronephrosis (OR = 7.8; 95% CI 0.77–78.6) and early removal of the double-J stent. A risk reduction of 7%(95% CI 2.2%–11.4%) was observed per extra-day of catheter maintenance. The optimal cut-off point is 55 days, ROC curve area: 0.77 (95% CI 0.62–0.92). Gender, distal ureteral diameter, pelvis diameter, dilatation balloon diameter and preoperative differential renal function did not affect the need for reimplantation. Conclusions The use of a double-J stent for at least 55 days seems to avoid the need for a secondary procedure. Therefore, we recommend removing the double-J catheter at least 2 months after the HBPD.  \nKeywords Primary obstructive megaureter · Endoscopy · High pressure balloon dilatation · JJ stent · Child  \nIntroduction  \nPrimary obstructive megaureter (POM) is a congenital obstruction of the distal ureter at the ureterovesical junction. Ureteral reimplantation is the standard treatment, but it is invasive, especially in infants [1, 2]. High-pressure balloon dilatation (HPBD) has emerged as a minimally invasive alternative since its description in 1998 [3] . Its longterm effectiveness has been documented, with a success rate between 87.3 and 100% of cases [4–6], making it an alternative first-line surgical option for POM [7] . However,  \n* Sonia Pérez-Bertólez [spbertolez@yahoo.es](spbertolez@yahoo.es)  \n1 Pediatric Urology Unit, Department of Pediatric Surgery, Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig de Sant Joan de Déu, 2. , 08950 Barcelona, Spain  \nthere's limited information on protective and risk factors for needing secondary procedures post-HPBD. To date, only the anatomical characteristics of the ureterovesical junction have been identified as relevant [8] . This study analyzes data from a POM cohort to identify these factors.  \nMaterial and methods  \nOur primary outcome was to study the need for surgical reintervention, including redo-HPBD, endoscopic treatment of secondary vesicoureteral reflux (VUR) and ureteric reimplantation. Our secondary outcome was to study the failure of endoscopic treatment requiring ureteric reimplantation.  \nA prospective cohort study was carried out. From 2007 to 2021, we prospectively registered all the patients who underwent HPBD for POM at our institution. The exclusion  \nc","cbCaiio9dV4RRIHD","https://ap.wps.com/l/cbCaiio9dV4RRIHD","pdf",942525,1,8,"English","en",105,"# Abstract\n## Purpose\n## Methods\n## Results\n## Conclusions\n# Introduction\n# Material and methods","[{\"question\":\"What stent duration did the study recommend to reduce secondary procedures?\",\"answer\":\"Using a double-J stent for at least 55 days, with recommendation to remove the catheter at least 2 months after HBPD.\"}]",1783719924,20,{"code":4,"msg":30,"data":31},"ok",{"site_id":24,"language":23,"slug":32,"title":13,"keywords":33,"description":14,"schema_data":34,"social_meta":77,"head_meta":79,"extra_data":81,"updated_unix":27},"risk-and-protective-factors-for-secondary-procedures-after-endoscopic-dilatation-of-primary-obstructive-megaureters","",{"@graph":35,"@context":76},[36,53,67],{"@type":37,"itemListElement":38},"BreadcrumbList",[39,43,47,50],{"item":40,"name":41,"@type":42,"position":20},"https://docshare.wps.com","Home","ListItem",{"item":44,"name":45,"@type":42,"position":46},"https://docshare.wps.com/document/","Document",2,{"item":48,"name":12,"@type":42,"position":49},"https://docshare.wps.com/document/healthcare/",3,{"item":51,"name":13,"@type":42,"position":52},"https://docshare.wps.com/document/risk-and-protective-factors-for-secondary-procedures-after-endoscopic-dilatation-of-primary-obstructive-megaureters/56208/",4,{"url":51,"name":13,"@type":54,"author":55,"headline":13,"publisher":57,"fileFormat":60,"inLanguage":23,"description":14,"dateModified":61,"datePublished":61,"encodingFormat":60,"isAccessibleForFree":62,"interactionStatistic":63},"DigitalDocument",{"name":9,"@type":56},"Person",{"url":40,"name":58,"@type":59},"DocShare","Organization","application/pdf","2026-07-10",true,{"@type":64,"interactionType":65,"userInteractionCount":4},"InteractionCounter",{"@type":66},"ViewAction",{"@type":68,"mainEntity":69},"FAQPage",[70],{"name":71,"@type":72,"acceptedAnswer":73},"What stent duration did the study recommend to reduce secondary procedures?","Question",{"text":74,"@type":75},"Using a double-J stent for at least 55 days, with recommendation to remove the catheter at least 2 months after HBPD.","Answer","https://schema.org",{"og:url":51,"og:type":78,"og:title":13,"og:site_name":58,"og:description":14},"article",{"robots":80,"canonical":51},"index,follow",{"doc_id":7,"site_id":24},{"code":4,"msg":5,"data":83},[84,88,92,96,101,106,109,113,117,120,124],{"id":20,"doc_module":4,"doc_module_name":45,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":46,"doc_module":4,"doc_module_name":45,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":52,"doc_module":4,"doc_module_name":45,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":45,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":45,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":11,"doc_module":4,"doc_module_name":45,"category_name":12,"show_sort_weight":107,"slug":108},40,"healthcare",{"id":21,"doc_module":4,"doc_module_name":45,"category_name":110,"show_sort_weight":111,"slug":112},"Research & Report",30,"research-report",{"id":114,"doc_module":4,"doc_module_name":45,"category_name":115,"show_sort_weight":28,"slug":116},9,"Religion & Spirituality","religion-spirituality",{"id":28,"doc_module":4,"doc_module_name":45,"category_name":118,"show_sort_weight":28,"slug":119},"World Cup","world-cup",{"id":121,"doc_module":4,"doc_module_name":45,"category_name":122,"show_sort_weight":121,"slug":123},10,"Lifestyle","lifestyle",{"id":125,"doc_module":4,"doc_module_name":45,"category_name":126,"show_sort_weight":97,"slug":127},19,"General","general"]