English

Abstract

Listen

Translate article

Ureteropelvic Junction Obstruction is a disease of newborns although it is manifested in later years of life in many cases. Various modalities for management of UPJ Obstruction are available today ranging from time tested open dismembered pyeloplasty to Robot assisted laparoscopic pyeloplasty. Various minimally invasive procedures in forms of endopyelotomy (both ante-grade and retro-grade), laparoscopic pyeloplasty, and robot assisted laparoscopic pyeloplasty are available for the urologist to choose from. In less advanced centers with little or no minimally invasive procedures availability, both in terms of lack of equipment and skilled surgeon open pyeloplasty remains the gold standard in management of ureteropelvic junction obstruction. Ever since its introduction by Anderson & Hynes dismembered pyeloplasty is preferred worldwide due to its universal application and excellent success rates. Non dismembered techniques of pyeloplasty are considered useful only is specific conditions. Increased vascularity of the anastomotic segment due to incomplete resection is very helpful for better outcome. This study aims to compare the outcome of dismembered pyeloplasty with non dismembered pyeloplasty (when not contraindicated). If the results obtained are comparable then it could be assumed that when not contraindicated non dismembered pyeloplasty can be considered in place of dismembered pyeloplasty to utilize the advantage of having better blood supply at the site of anastomosis. Obstruction of the urinary tract can occur during fetal development, childhood, or adulthood. The point of obstruction can be as proximal as the calyces and as distal as the urethral meatus. The cause of obstruction may be congenital or acquired and benign or malignant. The impact of the obstruction is influenced by the extent or degree of obstruction (partial or complete, unilateral or bilateral), its chronicity (acute or chronic), the baseline condition of the kidneys, the potential for recovery, and the presence of other mitigating factors such as urinary infection. These may ultimately lead to permanent renal damage, which may result in limiting the excretion of metabolic wastes and altering water and electrolyte balance.