R.E.N.A.L nephrometry score predicts early tumor recurrence and complications after percutaneous ablation: a 5-year experience

Studer neobladder (N1⁄43), Indiana pouch (n1⁄42), and ureteroileal diversion (N1⁄41). Ten patients had undergone urological surgery for transitional cell carcinoma, one for trauma, and one for neurogenic bladder. Seven strictures were left-sided and five were on the right. PCBU balloon sizes ranged from 5to 8-mm. Immediately following each PCBU, ureteric patency was assessed and percutaneous nephroureteral stents were placed. Follow-up antegrade nephrostograms were performed at 4-6 weeks intervals. Based upon the nephrostogram and clinical findings, patients underwent either conversion to nephrostomy, repeat dilatation and catheter exchange, or catheter removal. Technical success was defined as the ability to inflate the PCB to profile during the ureteroplasty. Clinical success was defined as attainment of tube-free existence. Failure time was defined as the interval between PCBU and the point at which the stenosis recurred and required re-intervention (surgery or repeat dilation) Results: Immediate technical success of PCBU was 100%. No deaths, or bleeding requiring transfusion or surgery occurred. A single patient was lost to follow-up. Clinical success was achieved in 8 /11 (73%) of the patients available for follow-up. The median failure time of PCBU for all patients, including those without clinical success, was 28 months (95% CI [0,52]. Of patients who achieved clinical success, the median failure time was 40 months (95% CI [5, na]). In addition, for those who achieve clinical success, failure rate was estimated at 33% at 25 months and 73% at 52 months. Conclusion: PCBU can to be a safe and effective treatment alternative to surgery in patients with uretero-enteric anastomotic strictures. Patients that achieve clinical success will generally achieve 3 or more years of tube free existence.