Five-Year experience with pyeloplasty using intubated and nonintubated techniques

Abstract

Background: Ureteropelvic junction obstruction (UPJO) is an obstruction of urine flow from the renal pelvis to the ureter. This condition can be caused by congenital and acquired due to intrinsic or extrinsic factors. UPJO due to acquired conditions such as secondary to inflammation, passage stones, or ureteric folds is less common. In case of suspected UPJO, the critical decision to be made depends on the correlation between the radiologic findings and the physiologic picture. There have been recent and serious trials to perform the surgical repair of UPJO without intubation, with reservation of double J (DJ) stents and nephrostomy tubes for complex cases. The Aim of Study: The aim of the study was a comparison of the time of drain removal, hospital stay, complications, and the end result of surgery in intubated and nonintubated UPJO repair. Patients and Methods: A retrospective case serious study performed in Urological Departments at Benghazi Medical Center and Al-Hawari Urology Center by reviewing 51 files of consecutive patients of UPJO admitted to the department of urology from May 2010 to 2015. All patients were diagnosed using different diagnostic tools. Forty-three cases underwent reconstructive surgeries as follows: 41 (95.3%) patients underwent Anderson-Hynes-dismembered (A-H-D) pyeloplasties and 2 (4.7%) patients underwent VY Foley pyeloplasties. Out of 41 cases underwent A-H-D pyeloplasties, there were six cases underwent concomitant pyelolithotomy. Results: The time of removal percutaneous perinephric tube drain was 7th to 9th postoperative days and 7.9 ± 0.5 days. The postoperative hospital stay for all cases range from 7 days to 10 days and the mean was 8.0 ± 0.8 days. Conclusions: Despite both intubated and nonintubated techniques of UPJO repair are comparable regarding the hospital stay postoperative complication, the tubeless surgical repair of UPJO is more suitable for children and superior to the intubated technique regarding the cost of DJ stent and nephrectomy tube.