title: Surgical results of anderson-hynes dismembered pyeloplasty without internal drainage in adults with ureteroplevic junction obstruction.
abstract: BACKGROUND
  Anderson-Hynes dismembered pyeloplasty is the gold standard therapeutic approach to ureteropelvic junction obstruction (UPJO). Use of a drainage method to protect the suture line from leakage is a matter of controversy.
  
  
  OBJECTIVE
  We have compared the surgical outcome of Anderson-Hynes dismembered pyeloplasty for UPJO repair, with or without internal stenting.
  
  
  METHODS
  Eighty-two patients with UPJO were evaluated from 1996 to 2002. Complicated or emergent cases were excluded. Classic standard dismembered pyeloplasty was performed. Internal drainage, with a double j catheter, was performed in several patients, randomly. Another drain was also placed in the retroperitoneal space. The follow-up of patients was planned weekly, with patient visits and urine analysis and intravenous pyelography (IVP) and diethylene-triamine-pentaacetate (DTPA) scan after one month.
  
  
  RESULTS
  The study group consisted of 51 male and 31 female patients, who were mostly in the age range of 20 - 40 years. Comparing the two techniques of pyeloplasty with or without internal drainage, there was no significant difference between groups regarding extravasation and anastomosis complications, such as leakage, stenosis, urinoma formation or evidence of obstruction on postoperative IVP or DTPA scan. However, a higher incidence of catheter related urinary symptoms and flank pain was reported among those with internal stent.
  
  
  CONCLUSIONS
  Pyeloplasty, with adequate spatulation, hemostasis and a watertight anastomosis, represents the mainstay of successful pyeloplasty and there may be no significant benefit for urethral stenting, especially in non-complicated cases.
authors.affiliation: Department of Urology, Mashhad University of Medical Sciences, Mashhad, IR Iran.
authors.forename: Aliasghar
authors.initials: A
authors.lastname: Yarmohamadi
authors.affiliation: Department of Urology, Mashhad University of Medical Sciences, Mashhad, IR Iran.
authors.forename: Parisa
authors.initials: P
authors.lastname: Saeedi
authors.affiliation: Department of Urology, Mashhad University of Medical Sciences, Mashhad, IR Iran.
authors.forename: Amir
authors.initials: A
authors.lastname: Hoghabrosadat
keywords: Drainage; Surgery; Urology