Endopyelotomy for treatment of ureteropelvic junction obstruction

A total of 14 patients underwent endopyelotomy at our institution for treating ureteropelvic junction (UPJ) obstruction (12 primary and 2 secondary obstructions) between March 1986 and July 1989. Radiographic evaluation of the patients with a minimum follow-up of 6 months demonstrated improvement in 11, while the remaining 3 were stable. These 3 were cases with primary obstruction and 2 of them had had an associated large redundant renal pelvis. No patients exhibited evidence of increased hydronephrosis or decreased renal function. Twelve of the 14 patients had had preoperative symptoms. Complete and partial remission of the symptoms was obtained in 11 and in 1 who was radiographically stable, respectively. Thus, our success rate for endopyelotomy was 75% in primary obstruction. Successful results were obtained in all the 2 cases with secondary obstruction. There was 1 patient with an intraoperative complication (extravasation) and a late complication related to the stent. However, the problems were minor and easily corrected. Our results suggest that careful selection of cases may lead to a high success rate in endopyelotomy for treating primary UPJ obstruction.