Long-term outcome of endopyelotomy for the treatment of ureteropelvic junction obstruction: how long should patients be followed up?

Purpose: To evaluate the long-term success rate of endopyelotomy for the treatment of ureteropelvic junction (UPJ) obstruction. Patients and Methods: Between January 1995 and December 2003, 85 endopyelotomies (10 percutaneous, 75 retrograde) were performed in 77 patients with a mean age of 35.2 ± 13.9 years. The mean number of procedures per patient was 1.14, with 69 patients undergoing a single procedure. Endopyelotomies were performed using either a cold knife (N = 26), Ho:YAG laser (N = 47), or hook electrode (N = 12). Treatment success was defined as symptomatic relief with radiographic resolution or stabilization of renal function, as judged by an excretory urogram or diuretic renogram. Kaplan-Meier analysis was used to determine the long-term probability of success. Results: With a median follow-up of 37.3 months (range 3–98 months), the overall success rate was 67.5%, and the median time to failure was 7.7 months (range 1–50 months). Kaplan-Meier estimates of success were 87.8% at 6 months, 76.9% a...