Analysis of the efficacy and risk factors of surgical treatment of recurrent UPJO in adults

Abstract

Background To compare the efficacy of secondary pyeloplasty and balloon dilation and to analyze the risk factors for secondary surgical failure in patients with recurrent uretero-pelvic junction obstruction (UPJO). Methods We retrospectively analyzed 65 patients with recurrent UPJO who underwent secondary surgery between September 2011 and March 2019, of whom 33 had complete baseline data and follow-up data. General clinical information, perioperative data, and follow-up results were collected from patients. Risk factors for surgical failure in patients with recurrent UPJO were analyzed using logistic regression. Results The failure rates of secondary pyeloplasty and balloon dilation in secondary surgery were 16.7% and 33.3%, respectively. Univariate analysis showed that ureteral stenosis length and operative time were associated with secondary pyeloplasty and balloon dilatation failure (p < 0.05), and ureteral stenosis length was an independent risk factor for secondary pyeloplasty failure (OR = 0.074, 95% CI: 0.006–0.864, p = 0.038). In the balloon dilation group, treatment failure rates were significantly lower in patients with stenotic segment lengths less than 1 ± 0.32 cm than in patients with stenotic segment lengths greater than 1 ± 0.32 cm (p = 0.019). Conclusions The secondary pyeloplasty may provide better benefit. Ureteral stricture length is an independent risk factor for failure of secondary pyeloplasty and a potential risk factor for balloon dilatation. Operation time is a potential risk factor for pyeloplasty and balloon dilatation.

Analysis of risk factors for stenosis after laparoscopic pyeloplasty in the treatment of ureteropelvic junction obstruction

“…The results of regression analysis conducted by Li [ 13 ] indicate that the length of the stenosis does not significantly influence the postoperative outcome. However, several studies [ 10 , 19 , 20 ] have reported that an excessively long stenosis (> 2 cm) is likely to result in poor postoperative recovery. Our logistic regression analysis revealed that the length of the stenosis segment is an independent risk factor for postoperative recurrence of stenosis (OR = 0.025, P = 0.011).…”

“…Despite advancements in technology and increased expertise, the success rate of pyeloplasty continues to improve. However, it is observed that approximately 2.5–10% of patients experience relapse after the initial operation [ 10 ]. Moreover, it is important to note that the recurrence rate of actual surgery may be higher due to insufficient follow-up time [ 11 ].…”