Long-term results of percutaneous endopyelotomy in the treatment of children with failed open pyeloplasty.
OBJECTIVE
We reviewed our experience with the safety and long-term efficacy of percutaneous endopyelotomy in children with secondary ureteropelvic junction obstruction who previously underwent open pyeloplasty.


METHODS
Nine patients a median of 7 years old underwent endopyelotomy between June 1985 and July 1995. Anderson-Hynes pyeloplasty had previously been performed in all children. Antegrade endopyelotomy was done with a cold knife in conjunction with balloon dilation in some cases. Postoperative stenting lasted 6 weeks.


RESULTS
The median interval between pyeloplasty and endopyelotomy was 7.5 months. Mean operative time was 240 minutes. Percutaneous endopyelotomy was successful in 8 of the 9 patients. One patient who required repeat endopyelotomy after 4 years is presently well at 5 years of followup. Average followup was 5.6 years (range 2 to 10). There was a low morbidity rate, including 1 case of urinary tract infection, 1 of pneumonia and 1 that required blood transfusion.


CONCLUSIONS
Percutaneous antegrade endopyelotomy is a safe, effective and durable alternative for children who previously underwent unsuccessful pyeloplasty.
Capolicchio
G
G
Department of Urology, Montreal Children's Hospital, Quebec, Canada.
Homsy
Y L
YL
Houle
A M
AM
Brzezinski
A
A
Stein
L
L
Elhilali
M M
MM
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000601:surgery*; D007682:Kidney Pelvis / Q000601:surgery*; D008297:Male; D013997:Time Factors; D017211:Treatment Failure; D014517:Ureteral Obstruction / Q000601:surgery*