Long-term results of retrograde endopyelotomy: a narrative review.

PURPOSE: Retrograde endopyelotomy has emerged as a minimally invasive alternative for treating ureteropelvic junction obstruction (UPJO), characterized by impaired urinary transport due to intrinsic or extrinsic factors. This narrative review evaluates the long-term outcomes of retrograde endopyelotomy, focusing on effectiveness, safety, complications, and reoperation requirements.

METHODS

A systematic search of PubMed, Google Scholar, and Scopus from 1990 to March 2024 identified 29 studies comprising 1238 adult patients.

RESULTS

Findings indicate that retrograde endopyelotomy, predominantly performed using Holmium:YAG lasers, achieved a mean success rate of 76.9%, with variability based on the type of obstruction and intervention methods. Success was inconsistently defined across studies, ranging from symptom resolution to imaging-based criteria. Complication rates averaged 12.5%, with urinary tract infections being the most common. Hospital stays were typically brief, with most patients discharged within 1-3 days.

CONCLUSION

Retrograde endopyelotomy, has the advantage of shorter recovery times and reduced invasiveness compared to open or laparoscopic approaches. Future studies should also explore advancements in laser technology, such as Thulium Fiber Laser, to optimize outcomes.