Abstract
We report on 109 patients with ureteropelvic junction obstruction (UPJO) treated according to the following algorithm: intrinsic stenoses were treated by laser endopyelotomy (LEP). We used retroperitoneoscopy with ureterolysis to manage significant extrinsic UPJO due to a crossing vessel and either non-dismembered pyeloplasty in cases of an anterior vessel or dismembered pyeloplasty in cases of a posterior crossing vessel. Children were mostly treated by open dismembered pyeloplasty. Analysis of the factors that influence the postoperative results in the group of 64 patients treated by LEP showed significance for the presence of extrinsic causes of UPJO and the underlying grade of hydronephrosis. Based on our own results and the review of the literature, minimally invasive approaches for the management of UPJO have been proven safe and effective with results comparable to open surgery.
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