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Lower polar renal vessels often cause idiopathic hydronephrosis. The Hellstrom operation with pelviureteric lysis offers an effective, simple treatment for this condition, showing positive clinical and radiological outcomes.
Area of Science:
- Urology
- Nephrology
- Surgical Innovation
Background:
- Idiopathic hydronephrosis can be caused by lower polar renal vessels.
- The Hellstrom operation is a potential treatment for such cases.
Purpose of the Study:
- To evaluate the efficacy of the Hellstrom operation combined with pelviureteric lysis for idiopathic hydronephrosis.
- To assess the effectiveness of different diagnostic methods in evaluating treatment outcomes.
Main Methods:
- A prospective study of 15 patients undergoing the Hellstrom operation and pelviureteric lysis.
- Assessment of results using clinical, radiological (IVU, diuretic urograms), and renographic criteria.
Main Results:
- The Hellstrom operation is a minor procedure with no risk of urine leakage or late stenosis.
- Clinical improvement and enhanced IVU/diuretic urogram appearance were more valuable indicators of success than deconvolution renography.
Conclusions:
- The Hellstrom operation combined with pelviureteric lysis is an effective and safe treatment for idiopathic hydronephrosis caused by lower polar renal vessels.
- Clinical and standard radiological assessments are superior to deconvolution renography for evaluating treatment success.
Abstract:
It is suggested that lower polar renal vessels are a common cause of idiopathic hydronephrosis and that the Hellstrom operation, combined with pelviureteric lysis, is an effective and simple treatment of such cases. The operation is described and a prospective study of 15 cases so treated is outlined. The results were studied by clinical, radiological and renographic criteria and showed that deconvolution renography is a less valuable means than the relief of pain and improvement in appearance of the IVU and diuretic urograms in assessing results. The operation is minor and cannot make things worse and there is no possibility of urine leakage or late stenosis.