SECONDARY URETEROPELVIC JUNCTION OBSTRUCTION: ENDOPYELOTOMY A BETTER OPTION

Objective: To evaluate the outcome of percutaneous antegrade endopyelot -omy as a primary intervention for Secondary Ureteropelvic junction (UPJ) ob-struction. Methodology: This study was conducted from 20th January 2011 to 19th January 2012 at Institute of Kidney diseases, Hayatabad, Peshawar. A sample of 31 cases having evidence of secondary ureteropelvic obstruction were list-ed for the study of which 21 cases as males and the rest females. Ultrasound, intravenous urogram and DTPA Scanwere carried out. Patients with severe hydronephrosis, renal function 2 cm stenosed segment were not included in the study. Stenosed segment was incised posterior-laterally until periureteral and peripelvic fat was visualized. At completion of 8 weeks postoperatively the ureteric stents were removed as day cases and the patients were evaluated at follow-up of 3 months and every subsequent 6 months in the out-patient department with data relevant collected on a predesigned proforma. Results: Demographically the findings were observed and mean age at both sexes was similar. The mean split GFR on the affected side was 36.5 mg/ml. The average time taken to completion of the procedure was 63 min. Hospital stay averaged 3.8 days (ranging form 2–6 days). Success rate was 81% (25 of 31) at 10.25 months. Failure was noted clinically in 6 cases with presentation variably at completion of first to the third month postoperatively. Conclusion: Percutaneous antegrade endopyelotomy has significant advan-tages in term of reduced hospital stay, shorter operative time, early postoper -ative recovery, minimal morbidity and decreased postoperative analgesic re-quirements. It is successful in selected patient who have good renal functions, no crossing vessels, mild to moderate hydronephrosis and dependent ureters. Normal 0 false false false EN-US X-NONE X-NONE