A ureteric balloon catheter is a

balloon catheter A balloon catheter is a type of "soft" catheter with an inflatable "balloon" at its tip which is used during a catheterization procedure to enlarge a narrow opening or passage within the body. The deflated balloon catheter is positioned, then in ...

intended for treating strictures of the ureter. In fact it is a double J stent on which a balloon is mounted. It is connected to a delivery device (pusher) to introduce it from the

bladder The urinary bladder, or simply bladder, is a hollow organ in humans and other vertebrates that stores urine from the kidneys before disposal by urination. In humans the bladder is a distensible organ that sits on the pelvic floor. Urine enters ...

into the

ureter The ureters are tubes made of smooth muscle that propel urine from the kidneys to the urinary bladder. In a human adult, the ureters are usually long and around in diameter. The ureter is lined by urothelial cells, a type of transitional epit ...

. The system comprises a non-return valve device, and a pusher with a stylet and two ports. The side port is for injecting contrast agent to inflate the balloon, while the straight port is for the guidewire. The catheter has a relatively large-diameter central lumen and a shaft of 2 mm (6 Fr.). The balloon is in two sections: a long narrow section or shaft and a larger cranial bulb. The larger cranial bulb prevents distal migration, while the longer narrow section maintains the increased diameter of a predilated stricture in the ureter section.

Stent placement and removal

A guide wire has to be placed in the ureter. After dilatation of the ureteric stricture with a high pressure dilatation balloon the guidewire remains in place to bring in the ureteric balloon catheter. The balloon is inflated by an injection of contrast medium via side port of the pusher and remains in situ while the expanded

urothelium Transitional epithelium also known as urothelium is a type of stratified epithelium. Transitional epithelium is a type of tissue that changes shape in response to stretching (stretchable epithelium). The transitional epithelium usually appears ...

heals. The stylet is used to detach the balloon catheter from the pusher. During the healing process urine drains through the wide central lumen while the balloon remains inflated. The ureteric balloon catheter may be used in conjunction with a double J stent for additional drainage. To remove the catheter after several weeks the balloon is deflated by snipping the distal end of the catheter. The catheter can then safely be pulled out.

Indications

The ureteric balloon catheter is intended to cure two major types of diseases: :* Ureteropelvic junction obstruction (also called UPJ obstruction or Pelvic-ureteric junction obstruction PUJO) caused by intrinsic wall factors as

fibrosis Fibrosis, also known as fibrotic scarring, is a pathological wound healing in which connective tissue replaces normal parenchymal tissue to the extent that it goes unchecked, leading to considerable tissue remodelling and the formation of perma ...

and / or

hypertrophic Hypertrophy is the increase in the volume of an organ or tissue due to the enlargement of its component cells. It is distinguished from hyperplasia, in which the cells remain approximately the same size but increase in number.Updated by Linda J. ...

wall problems. : :::and :* Brickers bladder (also called

Ileal conduit An ileal conduit urinary diversion is one of various surgical techniques for urinary diversion. It has sometimes been referred to as the Bricker ileal conduit after its inventor, Eugene M. Bricker. It is a form of incontinent urostomy, and was de ...

) problems. Up to 10% of patients who undergo ileal conduit urinary diversion may go on to develop ureteroileal anastomotic stenosis. This can lead to obstructive symptoms as side pain, infection and finally deterioration in renal function which can be relieved by the treatment with this balloon catheter. An intervention according to this Overtoom procedure is significantly less invasive than the alternative treatments. The balloon is not intended to be used in case of obstructions by stones or

malignancies Malignancy () is the tendency of a medical condition to become progressively worse. Malignancy is most familiar as a characterization of cancer. A ''malignant'' tumor contrasts with a non-cancerous ''benign'' tumor in that a malignancy is not s ...

Stent placement and removal

Indications

References

Further reading