2006, Number 3
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Gac Med Mex 2006; 142 (3)
Surgical treatment of uretero pelvic junction obstruction.
Castillejos-Molina RA, Rodríguez-Covarrubias F, Feria-Bernal G, Gabilondo-Navarro F
Language: Spanish
References: 14
Page: 205-208
PDF size: 440.69 Kb.
ABSTRACT
Introduction: Currently there are many therapeutic options for ureteropelvic junction obstruction (UPJO). Open pyeloplasty is the gold standard with a success rate of approximately 90%. We describe our experience in the treatment of UPJO.
Material and methods: We conducted a retrospective and descriptive study among our patients with UPJO surgically treated at the Department of Urology of our institution from 1970 to 2002.
Results: 126 UPJO were diagnosed in 114 patients. The most common symptoms at diagnosis were: pain in 105 patients (92.1), urinary tract infection (UTI) in 37 (32.4%) and hematuria in 24 (21%). The most common associated diseases were urolithiasis in 34 cases, crossing vessels in 10 and horseshoe kidney in 5. 123 procedures were undertaken: 92 (74.8%) dismembered pyeloplasties, 13 (10.7%) Foley Y-V pyeloplasties, in 8 (6.5%) release of crossing vessel, 5 (4%) endopyelotomies, 2 (1.6%) pyeloplasties Scardino-Prince, 2 patients with renal allograft in whom an anastomosis of renal pelvis to native ureter was performed and 1 (0.8%) ureter-ileal anastomosis in a patient with retroperitoneal fibrosis.
The mean follow-up time was of 33.2 months. In 114 (92.7%) patients the procedure was successful. The overall complication rate was of 17.9% of which 2.4% were stricture recurrence associated with crossing vessels.
Conclusion: Open dismembered pyeloplasty is the most common treatment procedure for UPJO at our institution. We report successful results, low morbidity, preservation of renal function and improving symptoms.
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