[Surgical treatment of ureteropelvic junction stricture]

Forty-five patients with hydronephrosis due to pelviureteric junction stricture were operated on at Kaohsiung Medical College Hospital between 1971 and 1986. In unilateral cases, the left kidney was affected more frequently than the right (24 to 13), while 8 (18%) had bilateral ureteropelvic stricture. Of the 45 cases, 24 cases (53%) underwent Anderson-Hynes pyeloplasty, 5 cases underwent Y-V plasty, 5 cases underwent ureterolysis and 11 cases underwent simple nephrectomy due to severe hydronephrosis. Except for the 11 nephrectomy cases, 11 of the remaining 34 cases had ureteral catheter placement and 9 cases had double-J ureteral catheter placement, postoperatively; another 14 cases received no ureteral stent for draining urine. The results were very encouraging with clinical improvement in 64% of the patients, and improvement in the pelviocaliceal system and early appearance of contrast medium in the ureter in 47% of the patients. The results of pyeloplasty with and without a nephrostomy or ureteral stent were compared. Patients with a nephrostomy or ureteral stent tended to have an increased incidence of urinary tract infections and longer hospital stays. In general, the results of treatment were poorer for patients with a nephrostomy or ureteral stent, than for patients without.