Laser ureteroscopic endopyelotomy efficacy in pyeloureteral junction stenosis

Abstract

Introduction. Pyeloureteral junction stenosis (PUJS) is a condition that affects urinary drainage at level of the renal pelvis and upper ureter. It is found in approximately 1 in 500 newborns, with a higher prevalence in males (2:1 ratio). PUJS is the main cause of congenital hydronephrosis and can also be caused by other specific pathologies. Endoscopic management is the primary treatment for PUJS, particularly in cases of aperistaltic and <2cm intrinsic ureteral stenosis without aberrant vessels. Aim of the study. Efficacy assessment of endoscopic retrograde incision of PUJS for urinary drainage recovery and duration of postoperatory effect. Material and methods. 5 patients were operated, from November 2022 to February 2023. Each patient has been operated by using retrograde LASER endopyelotomy method. There were excluded patients with extrinsic ureteral obstruction, defected segment more than 2 cm, massive hydronephrosis, split renal function <20%, tumor in the obstruction area, high ureteral insertion, patients <18 years of age. Mean follow-up time of patients is 8 weeks. Results. One month after intervention patients were recalled for investigations. There were observed way more better results in the patients with grade 1 hydronephrosis than those with grade 2 (p = 0.002). All patients at 3-month postoperative follow-up reported resolution of symptoms. Conclusions. Efficacy of LASER endopyelotomy is 99.9% in first months of the follow-up, after double J stent extraction. More follow-up time and patients are required to present more statistically significant results.