Minimally invasive methods in treatment of pyeloureteral stenosis

The aim of this study was to present our experience of using four minimally invasive methods in treatment of pyeloureteral stenosis by percutaneous access. Fifty patients underwent different percutaneous operative procedures: the Korth's method, endopyeloureterotomy, the Fenger's plastic, and laparoscopic dismembered pyeloplasty. We classified results into 3 groups (outcome good, outcome intermediate, and outcome poor), depending on clinical improvement and the ultrasonography and diuretic renography findings six months after the operation. In 30 patients operated on by the method according to Korth, 23 patients (76.6%) had a good outcome, relative improvement was achieved in 4 patients (13.3%), and in 3 patients (10%) the result was poor. In 2 patients the transpelvic endopyelotomy was performed, and results were good in both cases. In 11 patients operated on by the percutaneous retroperitoneal pyeloplasty according to Fenger, the results were good in 72.7% of patients. Two patients were operated on by the dismembered pyeloplasty, another 2 by the ligature of crossing vessels, and finally the 3 patients operated on by the retrograde Laser incision on pyeloureteral junction, all showed good results. Minimal invasion operative methods in the treatment of pyeloureteral stenosis are safe for the patient and have a good final result.