Revisiting Vertical Flap Pyeloplasty in Pelviureteric Junction Obstruction: A Case Series

Abstract

Pelviureteric Junction Obstruction (PUJO) can cause recurrent Urinary Tract Infections (UTIs), pain, and loss of renal unit function. Surgical intervention is often required, and numerous treatment strategies have been employed. Vertical flap pyeloplasty was initially described as the technique of choice in PUJO patients with the large box-shaped extra-renal pelvis and longer segment strictures (usually >2 cm). In the present case series, 11 patients underwent vertical flap pyeloplasty for PUJO with a large extrarenal box-shaped pelvis. Demographic, perioperative, and follow-up data were recorded. Success was defined as symptomatic improvement and an improvement in early Diethylenetriamine Pentaacetate (DTPA) renogram at six months. In the present series, all 11 patients showed an improvement in Glomerular Filtration Rate (GFR) with an average improvement of 11.9 mL. The procedure was technically easier, less time-consuming, and produced acceptable results. Vertical flap pyeloplasty could be considered as a practical, technically easier, and effective treatment option in PUJO with a large extrarenal pelvis and long segment strictures.