[Treatment of ureteropelvic junction stenosis with cold blade retrograde endopyelotomy]

The classical treatment of ureteropelvic junction (UPJ) stenosis consists of open surgical resection-anastomosis. Endopyelotomy, a less invasive procedure, allows antegrade or retrograde endoscopic incision of this junction. The authors' experience of cold blade retrograde endopyelotomy (CBRE) is presented and compared with other techniques.

Thirteen patients (3 men and 10 women), with a mean age 55.3 years, underwent CBRE with ureteroscopic and fluoroscopic control for primary (10/13) or secondary (3/13) UPJ stenosis. The clinical and urographic efficacy of the method was assessed retrospectively.

Median operating times and hospital stays were 40 min and 4 days respectively. The postoperative complication rate was 15.4% (two urinary tract infections). Eleven of the 13 patients are currently symptom-free with a mean follow-up of 26.5 months. Follow-up urography (mean follow-up: 11.9 months) shows a satisfactorily revascularized junction in 84.6% of cases (1 asymptomatic stenosis, 1 symptomatic stenosis revised by open surgery).

Compared to the other treatments of UPJ stenoses, CBRE is a simple, minimally invasive technique, which reduces operating time and hospital stay and therefore presents a good cost-efficacy ratio.