title: The minimally invasive management of ureteropelvic junction obstruction in horseshoe kidneys.
abstract: OBJECTIVE
  Data regarding the treatment of ureteropelvic junction obstruction (UPJO) in horseshoe kidneys are limited. We performed a retrospective analysis of our experience with minimally invasive treatment of UPJO in patients with this anomaly.
  
  
  METHODS
  Between March of 1996 and March 2008, 9 patients with horseshoe kidneys were treated for UPJO at our institution. Of these patients, 6 were managed with retrograde endopyelotomy, 2 with laparoscopic pyeloplasty, and one by robotic pyeloplasty. Outcomes of these procedures were retrospectively reviewed.
  
  
  RESULTS
  A total of nine patients were available for analysis. Four of six patients who underwent endopyelotomy had available follow-up, with a mean of 56 months. The success rate for these patients was 75%. Two of three patients (67%) in the laparoscopic/robotic cohort were successfully treated with a mean follow-up of 21 months.
  
  
  CONCLUSIONS
  UPJO in horseshoe kidneys can pose a therapeutic dilemma. The minimally invasive treatment of these patients is feasible with good success rates for both endopyelotomy and laparoscopic/robotic pyeloplasty.
authors.affiliation: Department of Urology, Kimmel Cancer Center, Thomas Jefferson University Hospital, 1025 Walnut Street, Suite 1100, Philadelphia, PA 19107, USA. Costas.lallas@jefferson.edu
authors.forename: Costas D
authors.initials: CD
authors.lastname: Lallas
authors.forename: Raymond W
authors.initials: RW
authors.lastname: Pak
authors.forename: Christopher
authors.initials: C
authors.lastname: Pagnani
authors.forename: Scott G
authors.initials: SG
authors.lastname: Hubosky
authors.forename: Brent V
authors.initials: BV
authors.lastname: Yanke
authors.forename: Frank X
authors.initials: FX
authors.lastname: Keeley
authors.forename: Demetrius H
authors.initials: DH
authors.lastname: Bagley
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007668:Kidney / Q000002:abnormalities* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014513:Ureter / Q000002:abnormalities / Q000601:surgery; D014517:Ureteral Obstruction / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*