ENDOPYELOTOMY FOR HIGH-INSERTION URETEROPELVIC JUNCTION OBSTRUCTION

We assessed the results of endourologic treatment of patients with a p rimary ureteropelvic junction obstruction (UPJO) caused by high insert ion of the ureter into the renal pelvis (HIUPJO). A total of 10 patien ts 15 to 76 years old with preoperatively diagnosed HIUPJO were treate d. Acucise retrograde endopyelotomy was performed in eight patients an d percutaneous antegrade endopyelotomy in two. A stent was left in pla ce for an average of 5.3 weeks. The subjective success rate, based on patient questionnaire and analog pain scales, was 80% at 27 months' av erage follow-up. The objective success rate, based on diuretic renal s canning or Whitaker test, was 70% at 26 months' mean follow-up. Overal l, 60% of the patients had both an objectively and a subjectively succ essful outcome. The success rate for endopyelotomy in patients with UP JO caused by high insertion is similar to that reported for endopyelot omy in patients without high insertion. High insertion is not a contra indication to endopyelotomy.