Open pyeloplasty in adult patients with primary PUJ obstruction - experience at urology department, Nishtar hospital, Multan

ABSTRACT

To assess the clinical presentation of primary PUJ obstruction and outcome of pyeloplasty in adult patients. The study was carried out at the Department of Urology, Nishtar Hospital, Multan from June 2006 to June 2007. A total of 25 adult patients were included in the study. All patients were evaluated in terms of clinical presentation, physical examination and investigations. Different techniques of open pyeloplasty were performed in these patients. Out of 25 patients, 16 were male and 9 were females [male to female ratio was 1.8 1]. Age of patients ranged between 13 to 45 years. All patients underwent some form of open pyeloplasty. Thirteen patients [52%] had Culp Deweerd spiral flap pyeloplasty, 10 [40%] had Anderson Hynes pyeloplasty while 2 [8%] had Foley Y-V pyeloplasty. Minor complications like superficial wound infection [4 patients, UTI [4 patients] and minor anastomotic leakage [1 patients] was seen in early postoperative period. Twenty three [92%] patients had good symptomatic relief, improvement in overall GFR and drainage across PUJ on DTPA seen at 3 months, 6 months and one year follow up. PUJ obstruction is the most common congenital abnormality of ureter, less invasive procedures are available for treatment of PUJ obstruction, but the pyeloplasty is the most effective in relief of obstruction and can be performed safely