Late outcomes of laparoscopic pyeloplasty: a single institution study with follow-up longer than 5 years

Although most urologists agree that failures after laparoscopic pyeloplasty occur usually within a year after the operation, late failures are also reported.

To assess late results of laparoscopic pyeloplasty.

Seventy-eight of ninety-five patients who had been operated on between November 2001 and September 2009 were notified about the possibility of diuretic renography (DR). Excluded from the study were 3 patients who failed within 1 year after surgery, 2 others with late recurrences at 1.5 and 2.5 years postoperatively, 8 patients who were lost to follow-up immediately after the operation, 2 patients with equivocal DR after pyeloplasty and 2 cases with open conversion. Twenty-six (33.3%) patients responded to the notification. Mean follow-up was 89 months. In all patients DR, ultrasound, serum creatinine concentration, estimatated glomerular filtration rate and the assessment of symptoms were carried out. Success was defined as T1/2 ≤ 12 min and improved or stable differential renal function on DR.

Diuretic renography revealed no obstruction in 25/26 (96%) patients. One woman was not appropriately hydrated, which rendered the result of the investigation unreliable. Mean half time to tracer clearance was 6.74 min. Mean split renal function on the operated side was 44.62%. Mean pain strength according to the VAS scale was 1.54.

Our study seems to indicate that recurrence after laparoscopic pyeloplasty in the follow-up period longer than 5 years is very unlikely. However, until more data are available, patients should undergo long-term follow-up to receive the benefit of the operation.