URETEROSCOPIC ENDOPYELOTOMY AT A SINGLE SETTING

Purpose: Endopyelotomy has become the initial treatment of choice for ureteropelvic junction obstruction. Debate persists regarding the pref erred approach (percutaneous or ureteroscopic) and the need for preope rative stenting. We review our experience with ureteroscopic endopyelo tomy without preoperative stenting. Materials and Methods: We treated 21 patients a mean of 37 years old who had ureteropelvic junction obst ruction with ureteroscopy and without preoperative stenting. Endolumin al ultrasound was performed in all cases for imaging the periureteral anatomy. A minimum of I year of followup is available in all cases. Su ccess was defined as pain-free status with resolution of obstruction o n diuretic renal scintigraphy. Results: Success was achieved in 17 of 21 patients (81%). Complications included stent irritation, postoperat ive urinary tract infection and stent displacement requiring repositio ning in I case each. Crossing vessels in 57% of the patients affected success (67 versus 100% in those with and without crossing vessels, re spectively). No patient had significant hemorrhage. Conclusions: Urete roscopic endopyelotomy without preoperative stenting is effective and safe for ureteropelvic junction obstruction.