Endopyelotomy in the elderly

Elderly patients with ureteropelvic junction obstruction present higher risks for operative repair than younger patients and may benefit from a less invasive approach. We review 18 patients older than 65 years who underwent endopyelotomy for a primary (8) or secondary (10) ureteropelvic junction obstruction. Average followup was 32 months (range 3 to 80). Average operating time, including cystoscopy and patient positioning, was 85 minutes. Average hospital stay was 6.3 days. No intraoperative complications were encountered. One failure occurred immediately postoperatively and the patient underwent corrective pyeloplasty. One patient has had intermittent pain but a negative Whitaker test with no evidence of obstruction. The success rate is 88%. Endopyelotomy can be considered a safe and satisfactory procedure for initial treatment of significant ureteropelvic junction obstruction in the elderly.