ENDOPYELOTOMY - EXPERIENCE WITH 320 CASES

We were the first to initiate endopyelotomy in Hungary (in 1986) and i n Yemen and Pakistan (in 1993). Through the end of 1995, 320 cases of ureteropelvic junction (UPJ) stenosis have been operated upon, The pro cedure was performed under local anesthesia in adult patients and gene ral anesthesia in children, The minimum age of the patient was 4 years , while the oldest patient was 80 years of age, The UPJ was incised lo ngitudinally at the posterolateral aspect until the perinephric fat wa s seen, and a drain of 8F to 12F was inserted transrenally into the ur eter through a nephroscope, Patients soon left the hospital and were a ble to start working in 5 days (average). The drain was removed after 6 weeks. During the follow-up period, ultrasonic examination was perfo rmed each 3 months. The success rate (mean of three centers) came out to be 87%, Open pyeloplasty was performed in cases where the symptoms of pyelectasia were persisting and caused complaints and stenosis was present even after 6 months, In our opinion, endopyelotomy should be t he procedure of first choice for UPJ stenosis, because it is less trou blesome for the patient than open pyeloplasty, and the results are rea l encouraging.