Abstract

CASTILLEJOS-MOLINA, Ricardo Alonso; RODRIGUEZ-COVARRUBIAS, Francisco; FERIA-BERNAL, Guillermo  and  GABILONDO-NAVARRO, Fernando. Surgical treatment of ureteropelvic junction obstruction. Gac. Méd. Méx [online]. 2006, vol.142, n.3, pp.205-208. ISSN 2696-1288.

Introduction: Currently there are many therapeutic options for ureteropelvic junction obstruction (UPJO). Open pyeloplasty is the gold standard with a success rafe of approximately 90%. We describe our experience in the treahent of UPJO. Material and methods: We conducted a retrospective and descriptive study among our patients with UPJO surgically treated at the Department of Urology of our institution from 1970 to 2002. Results: 126 UPJO were diagnosed in 114 patients. The most common symptoms at diagnosis were: pain in 105 patients (92.1). urinary tract infection (UTI) in 37 (32.4%) and hematuria in 24 (21 %). The most common associated diseases were urolithiasis in 34 cases, crossing vessels in 10 and horseshoe kidney in 5. 123 procedures were undertaken: 92 (74.8%) dismembered pyeloplasties, 13 (10.7%) Foley Y-V pyeloplasties, in 8 (6.5%) release of crossing vessel, 5 (4%) endopyelotomies, 2 (1.6%) pyeloplasties Scardino-Prince, 2 patients with renal allograft in whom an anastomosis of renal pelvis to native ureter was performed and 1 (0.8%) ureter-ileal anastomosis in a patient with retroperitoneal fibrosis. The mean follow-up time was of 33.2 months. In 114 (92.7%)patients the procedure was successful. The overall complication rate was of 17.9% of which 2.4% were stricture recurrence associated with crossing vessels. Conclusion: Open dismembered pyeloplasty is the most common treatment procedure for UPJO at our institution. We report successful results, low morbidity, preservation of renal function and improving symptoms.

Keywords : Ureteropelvic; junction obstruction; open dismembered pyeloplasty.