Laparoscopic management of ureteropelvic junction obstruction in patients with upper urinary tract anomalies.
OBJECTIVE
We report our experience with the laparoscopic management of ureteropelvic junction obstruction in patients with upper urinary tract abnormalities.


METHODS
Between July 1994 and May 2002, 7 men and 4 women with upper urinary tract anatomical abnormalities were referred to our institution for management of symptomatic ureteropelvic junction obstruction. Anomalies included horseshoe kidneys in 5 cases, pelvic kidneys in 3, a pancake kidney in 1, a malrotated kidney in 1 and a duplicated collecting system in 1. Three patients had associated renal stones that were extracted during reconstruction. Mean patient age was 37.4 years (range 25 to 60). One patient had undergone a previously unsuccessful endopyelotomy and 2 had a history of abdominal surgery.


RESULTS
Mean operative time was 195 minutes (range 85 to 403) and mean estimated blood loss was 122 cc (range 20 to 300). No patient in this series required transfusion. Average length of hospital stay was 3.2 days (range 2 to 5). Renal function failed to improve after surgery in 1 patient with poor renal function and severe hydronephrosis. The remaining 10 patients (91%) had durable clinical and/or radiographic success during a followup of 32.6 and 21.3 months, respectively. There were no major complications.


CONCLUSIONS
Laparoscopic pyeloplasty is an effective treatment alternative for ureteropelvic junction obstruction associated with renal or urinary tract anomalies.
Bove
Pierluigi
P
Brady Urological Institute, The Johns Hopkins Medical Intitutions, Baltimore, Maryland 21287-8915, USA.
Ong
Albert M
AM
Rha
Koon-Ho
KH
Pinto
Peter
P
Jarrett
Thomas W
TW
Kavoussi
Louis R
LR
D000328:Adult; D005260:Female; D006801:Humans; D007668:Kidney / Q000002:abnormalities*; D007682:Kidney Pelvis; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D014517:Ureteral Obstruction / Q000150:complications / Q000601:surgery*