# Sequential dilatation of two balloons and double D-J stents for therapy of ureteroenteral anastomotic stricture in patients following radical cystectomy and Bricker urinary diversion

## TL;DR

This study examines a treatment for ureteral strictures after bladder removal surgery, finding that using two balloons and double stents is safe and effective.

## Contribution

The study introduces a sequential balloon dilation and double stent method for treating ureteroenteral strictures after cystectomy.

## Key findings

- Sequential dilation with two balloons and twin D-J stents showed a success rate of 61.5%.
- The procedure was safe with no serious complications like bleeding or intestinal injury.
- Sequential dilation required longer hospital stays and surgery time compared to single dilation.

## Abstract

To determine the safety and efficacy of successive retrograde dilatation of two balloons and a double D-J stent for the treatment of ureteroenteral anastomotic strictures in patients who had undergone radical cystectomy and Bricker urinary diversion.

A total of 25 patients with ureteroenteral anastomotic stricture following radical cystectomy and Bricker urinary diversion were treated with sequential dilatation of two balloons (F18 and F24), while the remaining other 32 patients were only dilated once. All patients were treated with ureteroscope or flexible ureteroscope-guided retrograde implantation of twin D-J stents (F5).

Sequential dilation required significantly longer hospital stay and surgery time than single dilation. When sequential dilatation was compared to single dilatation, both the length of stay and the time it took to do the operation were clearly longer. After a follow-up of 6 to 24 months, the success rate of sequential dilatation was 61.5%, in comparison to 58.847.1% for single dilatation (P=0.83<0.05). All patients did not appear to have serious complications, such as hemorrhage, intestinal injury, or egression of the stent. No serious complications occurred in all patients, such as hemorrhage, intestinal injury, or egression of the stent.

Sequential retrograde dilatation with two balloons and double D-J stents is thought to be safe and effective for uretero-intestinal anastomotic strictures in patients having with brick ureteral diversions, and it is associated with fewer sequelae. It is worthwhile for clinical purposes.