The Y-V pyeloplasty revisited.
OBJECTIVE
To present a new method of laparoscopic Y-V pyeloplasty to treating ureteropelvic junction (UPJ) stenoses in patients with enlarged renal pelvis. Y-V pyeloplasty for the correction of UPJ stenosis has become well known. Despite its simplicity and good anatomic and functional results, there is no reduction of renal pelvic size and thus Y-V pyeloplasty has not been recommended for treating UPJ stenoses in patients with enlarged renal pelvis. We present a new method of laparoscopic Y-V pyeloplasty that includes simultaneous reduction of the renal pelvis and may extend the use for this procedure.


METHODS
A Y-V pyeloplasty, modified by extending the cranial limbs of the Y-shaped incision in an elliptic manner to eliminate redundant pelvic tissue, was used to reduce a hydronephrotic pelvis while widening the UPJ.


RESULTS
Three women aged 20-60 years underwent surgery for UPJ with this technique. The postoperative course was uneventful. After 10-43 months of follow-up there has been no evidence of obstruction.


CONCLUSIONS
The herein described modification allows extending the use of Y-V pyeloplasty to UPJ stenosis with enlarged renal pelvis.
Tsivian
Alexander
A
Department of Urologic Surgery, The E. Wolfson Medical Center, Holon, Israel. atsivian@hotmail.com
Tsivian
Matvey
M
Sidi
A Ami
AA
D005260:Female; D006801:Humans; D007682:Kidney Pelvis / Q000601:surgery*; D010535:Laparoscopy; D008875:Middle Aged; D014517:Ureteral Obstruction / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods; D055815:Young Adult