Ureteropelvic Junction Obstruction; Initial and Late Result of Pyeloplasties / 대한비뇨기과학회지

ABSTRACT

A clinical observation was made on 54 hydronephrotic kidneys due to UPJ obstruction during 4 years from January 1979 to April 1983. Operative procedures consisted of 18 primary nephrectomies, 28 dismembered pyeloplasties, 4 Foley Y-V pyeloplasties, and 4 lyses for fibrous band. The diuretic renal scan was very helpful in evaluating an equivocal UPJ obstruction as well as in predicting prognosis after the relief of obstruction. In pyeloplasties, the nephrostomy tube and ureteral stent were applied in the case of infants, solitary kidney, reopration and the presence of infection. The early success rate of dismembered pyeloplasties were 100% in the groups using nephrostomy tube and ureteral stent together and using neither of them, 78% in the group of using nephrostomy tube alone. Delayed opening which occurred in 9 cases out of 32 pyeloplasties (28%) had no relation with the use of nephrostomy tube or ureteral stent. The secondary operations for failed primary pyeloplasties were performed in 3 cases, all of which had urinary tract infection, suggesting the importance of the presence of preoperative UTI. Follow-up varied from 6 months to 4 years, and the appearance of postoperative excretory urogram was disappointing when compared to the clinical result's in regard to symptomatology and renal function. The late result showed success rate of 90% in dismembered pyeloplasty, 67% in non-dismembered pyeloplasty and 33% in band lysis.