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Related Experiment Videos

Is open pyeloplasty still justified?

N Arun1, N S Kekre, V Nath

  • 1Department of Urology, Christian Medical College and Hospital, Vellore, India.

British Journal of Urology
|October 6, 1997
PubMed
Summary
This summary is machine-generated.

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Open pyeloplasty is a highly effective treatment for pelvi-ureteric junction (PUJ) obstruction, offering a high success rate for pain relief and preserving renal function. Complications are minimal, establishing it as a gold standard treatment.

Area of Science:

  • Urology
  • Surgical Outcomes
  • Pediatric Surgery

Background:

  • Pelvi-ureteric junction (PUJ) obstruction is a common congenital anomaly requiring surgical intervention.
  • Open pyeloplasty has historically been the primary treatment modality for PUJ obstruction.

Purpose of the Study:

  • To evaluate the success rate, complication profile, and overall morbidity associated with open pyeloplasty.
  • To identify factors influencing surgical outcomes in patients with PUJ obstruction.

Main Methods:

  • Retrospective analysis of 63 patients (66 pyeloplasties) with confirmed PUJ obstruction.
  • Data collected included patient demographics, clinical presentation, renal function (serum creatinine, isotopic renography), surgical technique, and follow-up duration (mean 15.5 months).

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Main Results:

  • Open pyeloplasty demonstrated a high success rate, with 98% pain relief and 92% of patients maintaining or improving renal function.
  • Complications included persistent PUJ obstruction (4 cases), urinary leakage (2 cases), and transient vesico-ureteric obstruction (2 cases). Non-intubated procedures had no complications.
  • Favorable factors for successful outcomes included younger age, absence of urinary tract infection, and no palpable mass.

Conclusions:

  • Open pyeloplasty remains the most effective and durable treatment for pelvi-ureteric junction obstruction.
  • Newer endoscopic techniques should be rigorously compared to open pyeloplasty, the established gold standard, before widespread adoption.