Technology Based Treatment for UreteroPelvic Junction Obstruction.
Weil R Lai1, Carrie A Stewart1, Raju Thomas1
1Department of Urology, Tulane University School of Medicine , New Orleans, Louisiana.
Journal of Endourology
|August 24, 2016
Summary
Open pyeloplasty was the traditional surgery for ureteropelvic junction obstruction (UPJO). Minimally-invasive options like laparoscopy and robotics now offer alternatives, each with unique pros and cons.
Area of Science:
- Urology
- Surgical Innovation
Background:
- Ureteropelvic junction obstruction (UPJO) historically treated with open pyeloplasty.
- Advancements in endourology, laparoscopy, and robotics have introduced minimally-invasive alternatives.
Purpose of the Study:
- To review the chronological evolution of surgical techniques for UPJO.
- To discuss the current role of various approaches in UPJO management.
Main Methods:
- Review of historical and contemporary surgical techniques for UPJO.
- Comparative analysis of open, laparoscopic, and robotic pyeloplasty.
Main Results:
- Minimally-invasive techniques are now accepted alternatives to open surgery for UPJO.
- Each surgical approach presents distinct advantages, disadvantages, equipment requirements, invasiveness, and surgeon experience dependencies.
Conclusions:
- The management of UPJO has evolved significantly with the adoption of minimally-invasive surgical options.
- Understanding the nuances of each technique is crucial for optimal patient care in UPJO treatment.
Related Concept Videos
01:25Urinary Tract Calculi VI: Surgical Management
753
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
753
01:30Urinary Tract Calculi III: Medical Management
311
The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
311
01:22Ureters
1.9K
The ureters are retroperitoneal tubes located on either side of the vertebral column. They are responsible for transporting urine from each kidney to the urinary bladder. These tubes have thick walls and are approximately 25-30 cm long. Their diameter is around 10 mm at the renal pelvis, gradually narrowing to 1 mm as the ureter obliquely enters the posterior bladder wall through the ureteric orifices. The shape of these orifices is slit-like, which helps to prevent urine backflow toward the...
1.9K
01:22Imaging Studies V: Intravenous Urography and Retrograde Pyelography
2.3K
IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
2.3K
01:26Kidney Transplant II: Surgical Procedure
675
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
675
01:28Urinary Tract Calculi V: Nursing Management
396
AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
396