ENDOPYELOURETEROTOMY VIA THE TRANSPELVIC EXTRA-URETERAL APPROACH

We have developed a new procedure - endopyeloureterotomy via the trans pelvic extra-ureteral approach. From September 1988 to March 1994, we have treated 72 patients with ureteropelvic junction obstruction in 73 procedures and had a success rate of 89%. Causes were primary obstruc tion in 60 cases, post-operative scars in four, scars from inflammatio n of renal calculi in four, failure of previous endopyelotomy in three and scars from tuberculosis in two. The length of the stenotic segmen t ranged from 0.2 to 6.5 cm (mean: 1:8 cm) Follow-up ranged from 6 to 69 months (mean: 24 months). It showed that 21 of 73 procedures (28.8% ) had completely removed the ureteropelvic junction obstruction, 44 pr ocedures (60.3%) had reduced the obstruction, and eight procedures had failed to bring about a decrease in obstruction. Longterm follow-up o f 50 patients for 1 year or more showed that there was no recurrence o f stenosis at all after the examination at 6 months after operation. O ur new technique has proven efficacious in treating ureteropelvic junc tion obstruction.