title: Percutaneous endopyelotomy in infants and young children after failed open pyeloplasty.
abstract: OBJECTIVE
  We assessed the efficacy and safety of percutaneous endopyelotomy in infants and young children with secondary ureteropelvic junction obstruction after previous open pyeloplasty.
  
  
  METHODS
  Three boys and 2 girls with persistent ureteropelvic junction obstruction after open pyeloplasty underwent percutaneous antegrade cold knife endopyelotomy via an 18F nephrostomy tract.
  
  
  RESULTS
  Percutaneous endopyelotomy was successfully performed in all 5 children with minimal complications. At a mean followup of 2.5 years endopyelotomy was successful in 4 of the 5 children based on the absence of symptoms, normal pressure-perfusion studies and normal or improved diuretic renal scintigraphy studies. One child in whom endopyelotomy failed underwent successful ureterocalicostomy.
  
  
  CONCLUSIONS
  Percutaneous antegrade endopyelotomy is a safe and efficacious method of treating secondary ureteropelvic junction obstruction in children. This method offers a minimally invasive alternative to conventional repeat open pyeloplasty.
authors.affiliation: Department of Surgery, University of Michigan School of Medicine, Ann Arbor, USA.
authors.forename: G J
authors.initials: GJ
authors.lastname: Faerber
authors.forename: M L
authors.initials: ML
authors.lastname: Ritchey
authors.forename: D A
authors.initials: DA
authors.lastname: Bloom
mesh_terms: D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007682:Kidney Pelvis / Q000601:surgery*; D008297:Male; D015607:Stents; D014517:Ureteral Obstruction / Q000601:surgery*