[Percutaneous "sandwich" endopyeloplasty technique: a new endourological measure for ureteropelvic junction obstruction].

OBJECTIVE

To report a new endourological technique-percutaneous "sandwich" endopyeloplasty for ureteropelvic junction obstruction (UPJO).

METHODS

In the study, 71 patients with UPJO had endopyeloplasty by percutaneous balloon dilation before and after endopyelotomy, so called "sandwich" endopyeloplasty. The ureter stent was removed after 2 months and all the patients were followed up at least 12 months by ultrasound, intravenous urogram (IVU) or renal scintigraphy.

RESULTS

There were 12 patients with primary UPJO, and 59 patients with iatrogenic UPJO after pyelolithotomy, pyeloplasty, ureteroscopic lithotripsy or percutaneous nephrolithotomy. The mean length of stricture was (1.4±0.8) mm while 5 cases had complete stenosis ureteropelvic junction (UPJ). The mean glomerular filtration rate (GFR) of the affected kidney was (19.8±10.8) mL/min.69 patientshad one-stage operation successfully and 2 patients with complete UPJ stenosis were recanalized in the secondary procedures. The mean time of the operation was (39.3±24.2) min. The complications included 1 case of hemotoma, and 2 cases with residual stones. In the follow-up period, 7 patients were re-obstructed.

CONCLUSION

Percutaneous "sandwich" endopyeloplasty shows good results for UPJO of selected patients with simple operation, minimal invasiveness, quick recovery and few severe complications.