Treatment of ureteropelvic junction obstruction by endopyelotomy

Endoscopically controlled incision of the ureteropelvic junction (UPJ) (endopyelotomy) has become an accepted form of treatment for both primary and secondary obstruction. The procedure may be performed using either an antegrade, percutaneous technique or via a retrograde approach. Success rates range from 61 to 86% in large series, which is slightly inferior to results of open pyeloplasty. However, the length of hospitalization and recovery period are significantly lessened with an endoscopic approach, and it appears that endopyelotomy should be the initial procedure of choice for most adults with UPJ obstruction.