[Retrograde endopyelotomy using Holmium-Yag laser for uretero-pelvic junction obstruction].
OBJECTIVE
To evaluate our results of retrograde laser endopyelotomy for uretero-pelvic junction obstruction.


METHODS
Retrospective study of 27 consecutive retrograde laser endopyelotomies performed on 24 patients over a six years period (June 1999 to July 2005). Sixteen stenoses were primary. The level of obstruction was severe in 13 patients and moderate in 14 patients. A polar pedicle was diagnosed by pre-operative CT-angiography in seven cases. Balloon dilatation was performed in 17 procedures. A double J ureteral stent remained in place for six weeks mean. We evaluated results by a clinical examination and an excretory urography (at 1 and 6 months then annually). Mean follow-up was 35+/-22.7 months.


RESULTS
Mean operating time and mean length of hospital stay were 49.8+/-17.9min and four days (range: 2-10 days). Two cases of pyelonephritis were observed. The overall success was 70%. In the eight unresolved cases, the failure appeared at 2.7+/-1 month mean. Success criteria were moderate level of obstruction and primary junction. Here, patients so selected have 100% of success.


CONCLUSIONS
Study confirmed retrograde laser endopyelotomy was safety with a short length of hospital stay. This minimally invasive procedure should be reserved to primary moderate stenoses without polar pedicle.
Savoie
P-H
PH
Service d'urologie et de transplantation rénale, hôpital La Conception, 149, boulevard Baille, 13006 Marseille, France. phsavoie@hotmail.fr
Lechevallier
E
E
Crochet
P
P
Saïdi
A
A
Breton
X
X
Delaporte
V
V
Coulange
C
C
D000328:Adult; D005260:Female; D006801:Humans; D007682:Kidney Pelvis / Q000601:surgery*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D012189:Retrospective Studies; D014517:Ureteral Obstruction / Q000601:surgery*