The management of secondary pelvi‐ureteric junction obstruction – a comparison of pyeloplasty and endopyelotomy. (January 2014)

• Record Type: Journal Article
• Authors: Vannahme, Milena; Mathur, Sunil; Davenport, Kim; Timoney, Anthony G.; Keeley, Francis X.
• Is Part Of: BJU international. Volume 113:Number 1(2014:Jan.)
• Page Start: 108
• Page End: 112
• Publication Date: 2014-01
• Subjects: Genitourinary organs -- Diseases -- Periodicals; Genitourinary organs -- Surgery -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1111/bju.12454
• Languages: English
• ISSNs: 1464-4096

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bju12454-sec-0001" sec-type="section"> <title>Objective</title> <p> <list id="bju12454-list-0001" list-type="bullet"> <list-item> <p>To review our experience in the management of secondary pelvi‐ureteric junction obstruction (PUJO) comparing endopyelotomy with pyeloplasty.</p> </list-item> </list> </p> </sec> <sec id="bju12454-sec-0002" sec-type="section"> <title>Patients and Methods</title> <p> <list id="bju12454-list-0002" list-type="bullet"> <list-item> <p>We retrospectively analysed our database of 58 patients having undergone operative management of PUJO after failed primary management, including 41 with failed pyeloplasty and 17 failed endopyelotomy.</p> </list-item> <list-item> <p>Outcomes included mercapto‐acetyltriglycine (MAG3) drainage capacity, symptomatic control and need for further intervention. Success was defined as freedom from failure in all three.</p> </list-item> </list> </p> </sec> <sec id="bju12454-sec-0003" sec-type="section"> <title>Results</title> <p> <list id="bju12454-list-0003" list-type="bullet"> <list-item> <p>Patients undergoing secondary pyeloplasty had better outcomes than endopyelotomy for symptomatic success (87.5% vs 74%), resolution of obstruction on MAG3 renography (96% vs 74%), and no need for further intervention (96% vs 71%).</p> </list-item> <list-item> <p>Overall success was 87.5% for pyeloplasty compared with 44% after secondary endopyelotomy.</p> </list-item> </list> </p> </sec> <sec id="bju12454-sec-0004" sec-type="section"> <title>Conclusion</title> <p> <list id="bju12454-list-0004" list-type="bullet"> <list-item> <p>Outcomes of pyelopasty for secondary PUJO were superior when compared with endopyelotomy.</p> </list-item> </list> </p> </sec> </abstract>