[Resection of pyelo-ureteral junction without external urinary drainage for primary ureteral stenosis]

Abstract

During a 3-year period 30 consecutive patients (20 women and 10 men) with primary ureteropelvic junction obstruction underwent open dismembered pyeloplasty associated with the placement of an indwelling double pigtail stent via antegrade approach. Renal stones were removed in 8 cases, multiple nephrotomies being necessary in 2 patients. 2 men had temporary urinary leakage. Mean hospitalization time after surgical procedure was 9,8 days, but last 18 patients were discharged after only 7,3 days, Stents were removed 4 to 5 weeks after operation. With 1 to 4 years post-operative follow-up, successful treatment with relief of obstruction was achieved in all 38 patients without secondary stricture. Open pyeloplasty with double pigtail stenting appears to be a safe and successful procedure for the treatment of primary ureteropelvic junction obstruction in adults. Comparison with percutaneous endopyelotomy in terms of morbidity, duration of hospitalization and success rate appears to be in favor of open procedure, although secondary stricture may require endourological procedure.