Endopyelotomy - a Minimally Invasive Surgical Option for Pelvi-ureteric Junction Obstruction: a Study Of 34 Cases

Area of Science:

• Urology
• Minimally Invasive Surgery
• Nephrology

Background:

• Ureteropelvic junction (PUJ) obstruction affects renal units, causing symptoms and functional impairment.
• Traditional open pyeloplasty can be invasive; minimally invasive alternatives are sought.
• Endopyelotomy offers a less invasive approach to treat PUJ obstruction.

Purpose of the Study:

• To evaluate the efficacy and success rate of antegrade endopyelotomy for treating PUJ obstruction.
• To assess patient outcomes, including symptomatic and functional recovery.
• To determine the suitability of endopyelotomy across diverse patient populations.

Main Methods:

• A standardized antegrade percutaneous endopyelotomy technique was employed in 34 patients.
• Procedures utilized a single guide wire and cold knife, with a 48-hour nephrostomy tube and 6-week stent.
• Patients were followed for subjective and objective recovery using DTPA scans, IVU, and ultrasound for up to 1 year.

Main Results:

• A high success rate of 91.6% was observed up to 1 year postoperatively.
• Most patients experienced significant symptomatic and functional recovery.
• Minor complications included transient urinary tract infections and equivocal scan results, managed effectively.

Conclusions:

• Antegrade endopyelotomy is a highly successful and effective treatment for ureteropelvic junction obstruction.
• The procedure demonstrates broad applicability across various patient demographics and obstruction types.
• Endopyelotomy provides a viable, minimally invasive option with excellent long-term outcomes.