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Updated: May 31, 2026
03:57
Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis
Published on: July 8, 2025
Failure after laparoscopic pyeloplasty: prevention and management
Hung-Jui Tan1, Zaojun Ye, William W Roberts
1Department of Urology, Division of Endourology and Stone Disease, University of Michigan, Ann Arbor, Michigan, USA.
Journal of Endourology
|June 30, 2011
Summary
Laparoscopic pyeloplasty (LP) failure is uncommon but manageable. Nearly half of persistent ureteropelvic junction obstruction cases after LP can be successfully treated, often with minimally invasive endoscopic procedures.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Surgical Outcomes
Background:
- Laparoscopic pyeloplasty (LP) is a successful treatment for ureteropelvic junction (UPJ) obstruction.
- Strategies for managing LP failures are less well-documented.
Purpose of the Study:
- To report institutional experience with persistent or recurrent UPJ obstruction after LP.
- To identify factors associated with treatment failure and salvageability.
Main Methods:
- Retrospective chart review of 128 patients undergoing LP (1996-2008).
- Success defined by objective resolution of obstruction.
- Analysis of patient demographics, operative details, and salvage treatments.
Main Results:
- 82% of 102 evaluable patients had successful LP.
- 18 failures occurred, with 44% salvaged, many via endoscopic management.
- Factors associated with failure included diabetes, longer hospital stay, higher ASA score, and stent placement.
Conclusions:
- A significant proportion of laparoscopic pyeloplasty failures are salvageable.
- Endoscopic management is an effective salvage strategy for UPJ obstruction recurrence.
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