Ureteropelvic junction obstruction: treatment with percutaneous endopyelotomy

The authors review their experience with percutaneous endopyelotomy in the treatment of ureteropelvic junction obstruction. Twenty-four patients with symptoms of ureteropelvic junction obstruction underwent excretory urography, which revealed nonspecific narrowing in several cases. Angiography was performed in 14 patients suspected of having a vessel crossing at the junction, but such a vessel was found in only four, who subsequently underwent dismembered pyeloplasty. One patient was treated with decompression, but later required endopyelotomy. Nineteen patients underwent percutaneous endopyelotomy; in 11 of them, dilation with a balloon catheter was required to ensure complete disruption of the stenosis. After 6-36 months follow-up, 17 of the 19 patients were asymptomatic with no obstruction and two were asymptomatic with mild obstruction.