PERCUTANEOUS ANTEGRADE ENDOPYELOTOMY IN THE MANAGEMENT OF PELVIURETERIC JUNCTION OBSTRUCTION - INITIAL OUTCOME

Objective: The aims and objectives of our study were to evaluate the role of percutaneous antegrade endopyelotomy in the management of PUJ obstruction, in terms of success rate, operative time, postoperative parameters like hospital stay, postoperative complications (if any). Patients and Methods: From 1st June 2013 to October 2015, a total of 15 patients {9/ M; 6/F} of PUJO were enrolled in the study. The selection criteria included: Mild – Moderate hydronephrosis, Differential function > 30%, Stricture length < 2cm and absence of crossing vessel at PUJ. 9 patients with primary and 6 patients with secondary pelviureteric junction obstruction (following failed pyeloplasty) underwent percutaneous antegrade endopyelotomy using a Bugbee electrode/ Hot Knife and the results were analysed. Results: Total of 15 renal units were operated upon,9 patients having primary PUJO, and 6 having secondry PUJO (failed pyeloplasty).Mean age of patients was 33 years. There was moderate hydronephrosis in 66% of cases and mild hydronephrosis in 34% of cases. Percetenous antegrade endopylotomy was done in all 15 cases. Endopylotomy with simultaneous stone extraction was done in 3 patients. Mean operative time was 90 minutes. Mean hospital stay was 3.5 days. The success rate after one year in terms of symptomatic relief was in 81% (9/11). The success rate after one year in terms of DTPA improvement was 80% (12/15). There were no significant complications. Conclusion: Endopyelotomy remains a viable therapeutic option in a selected group of patients of ureteropelvic junction obstruction.