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Ureteronephroscopic endopyelotomy.

R V Clayman1, J W Basler, L Kavoussi

  • 1Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.

The Journal of Urology
|August 1, 1990
PubMed
Summary
This summary is machine-generated.

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Retrograde ureteronephroscopic endopyelotomy offers a less invasive treatment for ureteropelvic junction obstruction. This study shows promising results with minimal discomfort and high efficacy in patients.

Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Endourology

Background:

  • Percutaneous nephrostomy provides upper urinary tract access for treating ureteropelvic junction obstruction.
  • The traditional percutaneous approach, while less invasive than open surgery, causes significant patient discomfort due to large tract sizes (24-32F).

Purpose of the Study:

  • To evaluate the efficacy and safety of a less invasive retrograde ureteronephroscopic endopyelotomy for ureteropelvic junction obstruction.
  • To compare the outcomes with the traditional antegrade percutaneous approach.

Main Methods:

  • Ten patients (9 female, 1 male) with primary or secondary ureteropelvic junction obstruction underwent retrograde ureteronephroscopic endopyelotomy.
  • A 3 or 5F cutting electrode was used via a 12F rigid or 9.8-10.8F flexible ureteronephroscope.

Related Experiment Videos

  • Preoperative diagnosis was confirmed by furosemide washout renal scan and/or Whitaker test in 8 patients.

    • Main Results:

    • The average procedure duration was 180 minutes (245 minutes with concurrent Whitaker test).
    • Post-procedure, patients had a 7/14F ureteral stent for 6 weeks, with nephrostomy tube removal after 3 days and an average hospital stay of 5 days.
    • Follow-up averaged 12 months, with flank pain resolved in all patients and decreased or no obstruction demonstrated in 90% of patients via imaging or Whitaker test.

    Conclusions:

    • Retrograde ureteronephroscopic endopyelotomy is a promising, minimally invasive treatment for ureteropelvic junction obstruction, particularly in female patients.
    • The procedure demonstrates minimal morbidity and satisfactory efficacy, with a 90% objective success rate.