Ureteroscopic endopyelotomy in an ectopic kidney.

A patient with an ectopic, pelvic kidney with congenital ureteropelvic junction obstruction was treated by retrograde, ureteroscopic endopyelotomy without percutaneous access. Preoperative ureteral stent placement and angiography facilitated the procedure. The patient had an uneventful recovery with improved drainage from the involved collecting system demonstrated by renal scintigraphy 6 months postoperatively. Ureteroscopic endopyelotomy avoids the need for percutaneous access, which may be difficult in patients with ectopic, malrotated kidneys and appears particularly well suited to the treatment of ureteropelvic junction obstruction in such cases.