Endoscopic infundibulotomy in tuberculous renal infundibular stricture

To salvage the renal parenchyma, percutaneous endoscopic infundibulotomy was performed in 10 patients with a tuberculous renal infundibular stricture. Followup ranged from 12 to 31 months. The sites of stricture were the upper calix in 6 patients and the lower calix in 4. A cold knife was used to incise the stricture and a stent was retained for 6 to 8 weeks. Postoperative excretory urography revealed marked shrinkage of the dilated calix in 5 patients, moderate shrinkage in 3 and no change in 2 (success rate 80%). Of 2 failed cases partial nephrectomy was done in 1 and 1 is being followed. There was no significant complication except for 2 cases of pyelonephritis that was controlled with conservative treatment. In conclusion, endoscopic infundibulotomy is a safe, less invasive, successful and parenchyma salvageable procedure to treat tuberculous renal infundibular stricture.