Evaluation of Early and Late Clinical, Radiological and Scintigraphic Datas After Laparoscopic Pyeloplasty in Ureteropelvic Junction Obstruction

Abstract

Ureteropelvic junction obstruction(UPJO) causes inadequate transport of urine from the renal pelvis to the ureter. Laparoscopic pyeloplasty(LP) is increasingly preferred in patients with UPJO. We aimed to compare the clinical, radiological and scintigraphic findings before the treatment and the early and late progress of the patients underwent LP for UPJO. Sixty-eight cases underwent LP for UPJO(January 2010-May 2016) were included. Demographic characteristics, clinical findings, intraoperative characteristics, data on preoperative and postoperative clinical, radiological and scintigraphic follow-ups of the cases were evaluated retrospectively. LP was performed in 68 patients(51 males, 17 females) for UPJO. Twenty-four patients with antenatal hydronephrosis, 46 patients with abdominal pain, hematuria and urinary tract infection(UTI) findings were diagnosed with UPJO. Patients were preoperatively followed up by USG and DTPA-MAG3 imaging. During surgery, aberrant vessel in 13(19.1%) patients, malrotation in 4(5.8%) and polyp in one(1.4%) patient were detected. Thirteen patients(19.1%) underwent surgery with the transmesoolic approach, 55 patients(80.8%) underwent retrocolic surgery, 33 patients underwent laparoscopy-assisted extracorporeal pyeloplasty. In postoperative period, patients were followed up at 1st, 3rd, 6th months and in the first year with USG and at 6th months with DTPA-MAG3 imaging. Postoperative USG follow up showed a decrease in hydronephrosis(p<0.001), an increase in parenchymal thickness(p<0.001), and a decrease in caliceal dilatation(p<0.001). In scintigraphic data, renal function was increased but it is not statistically significant(p>0.05) and activated half-time was decreased(p<0.05) in postoperative period. LP is a surgical treatment method with successful results when performed with appropriate indications in experienced clinics.