C C Feng1, G Dong, Z Hang, H Jiang, Q Ding, Y Zhang, Z Wu. 1. Department of Urology, Huashan Hospital, Fudan University, 12 Central Urumqi Rd, Shanghai, PR China - drwuzhong@163.com;
Abstract
PURPOSE: To assess efficacy of laser endopyelotomy in both primary and secondary ureteropelvic junction obstructions (UPJOs) PATIENTS AND METHODS: Primary category consisted of 10 patients of congenital UPJOs. Secondary category was comprised of UPJOs in 12 status post pyeloplasty, 10 status post lithotomy, 5 status post shock wave lithotripsy, and 10 status post ureteroscopic lithotripsy. Ho:YAG laser endopyelotomy was performed in all subjects. Exclusion criteria included obstructions longer than 2 cm, ipsilateral upper urinary calculi and crossing vasculature. RESULTS: Mean operation time was 44 min. Average inpatient duration was 1.87 days. No major complication occurred. Follow-ups were at least 12 months. Success rate for single endopyelotomy was 82.5%, leaving 7 patients for a secondary endopyelotomy. Secondary UPJO due to failed pyeloplasty had a predilection of restenosis after endopyelotomy (P = 0.0005) compared to other aetiologies. CONCLUSIONS: Ho:YAG laser endopyelotomy is a safe and effective approach effective in both primary and secondary UPJO treatments.
PURPOSE: To assess efficacy of laser endopyelotomy in both primary and secondary ureteropelvic junction obstructions (UPJOs) PATIENTS AND METHODS: Primary category consisted of 10 patients of congenital UPJOs. Secondary category was comprised of UPJOs in 12 status post pyeloplasty, 10 status post lithotomy, 5 status post shock wave lithotripsy, and 10 status post ureteroscopic lithotripsy. Ho:YAG laser endopyelotomy was performed in all subjects. Exclusion criteria included obstructions longer than 2 cm, ipsilateral upper urinary calculi and crossing vasculature. RESULTS: Mean operation time was 44 min. Average inpatient duration was 1.87 days. No major complication occurred. Follow-ups were at least 12 months. Success rate for single endopyelotomy was 82.5%, leaving 7 patients for a secondary endopyelotomy. Secondary UPJO due to failed pyeloplasty had a predilection of restenosis after endopyelotomy (P = 0.0005) compared to other aetiologies. CONCLUSIONS: Ho:YAG laser endopyelotomy is a safe and effective approach effective in both primary and secondary UPJO treatments.
Authors: Bruce L Jacobs; Julie C Lai; Rachana Seelam; Janet M Hanley; J Stuart Wolf; Brent K Hollenbeck; John M Hollingsworth; Andrew W Dick; Claude M Setodji; Christopher S Saigal Journal: J Endourol Date: 2017-01-05 Impact factor: 2.942