New technique in managing ureteropelvic junction obstruction: percutaneous endoscopic pyeloplasty.

Abstract:

:Endopyelotomy is currently advocated for management of the obstructed ureteropelvic junction (UPJ). Healing of the stented UPJ occurs by secondary intention. Regardless of the method employed, success rates approach 85%. In order to increase the rate of success, we have devised a method of performing endopyelotomy in conjunction with endoscopic suturing of the incised UPJ. Two methods were developed to allow for the placement of a single absorbable monofilament suture. In the first method, endopyelotomy is carried out in the standard antegrade manner, and endoscopic suturing is performed with the use of a second retroperitoneal access sheath at the UPJ. In the second method, endoscopic placement of the suture is carried out through the standard renal access sheath, with suturing performed via the nephroscope. We have performed endoscopic pyeloplasty in eight patients. With a mean follow-up of 12 months, the procedure was successful in seven of these patients. Endoscopic suturing of the UPJ is technically demanding, but once sufficient expertise is gained, it may be utilized for immediate tissue coaptation, possibly decreasing urinary extravasation and, it is hoped, maximizing the caliber of the UPJ.

journal_name

J Endourol

journal_title

Journal of endourology

authors

Oshinsky GS,Jarrett TW,Smith AD

doi

10.1089/end.1996.10.147

subject

Has Abstract

pub_date

1996-04-01 00:00:00

pages

147-51

issue

2

eissn

0892-7790

issn

1557-900X

journal_volume

10

pub_type

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