Endourologic techniques for ureteropelvic junction obstruction therapy. Comparative animal study

Area of Science:

• Urology
• Minimally Invasive Surgery
• Surgical Techniques

Background:

• Ureteropelvic junction (UPJ) obstruction is a common cause of pediatric kidney disease.
• Traditional open pyeloplasty has been the gold standard, but minimally invasive techniques are gaining traction.

Purpose of the Study:

• To compare the efficacy and outcomes of three endourologic techniques for UPJ obstruction: laparoscopic pyeloplasty, Acucise endopyelotomy, and endoballoon rupture endopyelotomy.
• To evaluate these techniques in a porcine model.

Main Methods:

• A study was conducted on 24 female pigs, divided into three groups: laparoscopic pyeloplasty, Acucise endopyelotomy, and endoballoon rupture endopyelotomy.
• Ultrasonographic and fluoroscopic studies were used for analysis during obstruction induction, treatment, and follow-up.
• Postmortem evaluation was performed 15 weeks after treatment.

Main Results:

• Success rates were 87.5% for laparoscopic pyeloplasty and Acucise endopyelotomy, and 75% for endoballoon rupture endopyelotomy.
• Laparoscopic pyeloplasty showed significantly longer intervention times compared to endopyelotomy techniques.
• Significant differences in UPJ diameter evolution were observed between laparoscopic pyeloplasty and endoballoon rupture endopyelotomy.

Conclusions:

• Laparoscopic pyeloplasty results in fewer side effects and wider UPJ dilation.
• Endopyelotomy techniques, particularly in selected patients, offer comparable results to pyeloplasty.
• Endopyelotomy is a simpler and less invasive alternative for UPJ obstruction treatment.