The authors present a 5-year follow-up of endopyelotomy using a personal technique for cases of primary ureteropelvic junction obstruction. After percutaneous access has been gained via a lower calix, the technique involves wide opening of the renal pelvis and exploration of the peripelvic space before a 3- to 4-cm long sectioning of the ureter. The aim is to carry out all of the operation in full view and without the need for a large-caliber stent, in order to perform endopyelotomy also in pediatric patients or in presence of anomalous vessels. The follow-up demonstrates a good result in 80% of 46 patients aged 5 to 62 years; two patients underwent surgical repair. The authors think the antegrade transpelvic endopyelotomy is an endourologic operation whose results and feasibility parallel those of open surgery.
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Endopyelotomy is a minimally invasive option for treatment of ureteropelvic junction (UPJ) obstruction. Although largely supplanted by laparoscopic or robot-assisted laparoscopic pyeloplasty, it retains efficacy and utility in the absence of a crossing vessel in patients not fit for laparoscopy, patients with secondary obstructions or strictures, or those with stones requiring simultaneous treatment. Antegrade endopyelotomy is most commonly performed with scissors, cold knife, or more recently, using a Holmium laser.
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The authors present a 5-year follow-up of endopyelotomy using a personal technique for cases of primary ureteropelvic junction obstruction. After percutaneous access has been gained via a lower calix, the technique involves wide opening of the renal pelvis and exploration of the peripelvic space before a 3- to 4-cm long sectioning of the ureter. The aim is to carry out all of the operation in full view and without the need for a large-caliber stent, in order to perform endopyelotomy also in pediatric patients or in presence of anomalous vessels.
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The Authors describe their own technique of antegrade endopyelotomy for cases of primary ureteropelvic junction obstruction. After percutaneous access has been gained via the lower calix, the technique involves making a wide opening of the renal pelvis and exploring the peripelvic space in front of a 3 to 4 cm long section of the ureter. The aim is to carry out the operation with an unrestricted view and without the need for a large calibre stent, in order to perform endopyelotomy in pediatric patients or in the presence of anomalous vessels.
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