Laparoscopic nephroplication and nephropexy as an adjunct to pyeloplasty in UPJO with giant hydronephrosis

Jindal, Lokesh; Gupta, Anup Kumar; Mumtaz, Faiz; Sunder, Rani; Hemal, Ashok K.

doi:10.1007/s11255-005-4975-6

Cited by 7 publications

(8 citation statements)

References 7 publications

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“…Most giant hydronephrotic kidneys are non‐functional, making nephrectomy the procedure of choice [4,7,8,10]. However, attempts at the reconstruction of functional kidneys have been made [1–3,6,10,11]. Restoration of functional and anatomic changes in these cases is the main stay for management.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have reported on the effect of nephroplasty or nephroplication for reducing intrarenal dilatation and improving drainage [1–3]. Hemal et al .…”

Section: Discussionmentioning

confidence: 99%

“…There have been reports of functional giant hydronephrotic kidneys treated with reconstructive management [1,2,6,10,11]. These studies had several limitations, including the small number of patients, a short follow‐up and a lack of functional evaluation [1–3]. In the present study, we report and discuss the surgical treatment and long‐term outcome of patients with severe hydronephrosis secondary to UPJO at our institute.…”

Section: Introductionmentioning

confidence: 90%

“…However, surgery can sometimes be challenging, especially if the kidney and renal pelvis are dilated massively, and reconstruction of the UPJ alone is usually inadequate to improve drainage from the pelvicalyceal system. Nephroplication and nephropexy are useful adjuncts to improve drainage after the relief of obstruction in these kidneys [2,3].…”

Section: Introductionmentioning

confidence: 99%

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Long‐term functional and morphological outcome after pyeloplasty for huge renal pelvis

et al. 2010

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Study Type – Therapy (case series) Level of Evidence 4 OBJECTIVE • To evaluate the functional and morphological outcome after open pyeloplasty for ureteropelvic junction obstruction (UPJO) with huge renal pelvis. PATIENTS AND METHODS • A retrospective review of all cases who underwent pyeloplasty for huge renal pelvis was conducted. • Records were evaluated with respect to age at presentation, preoperative imaging, surgical details and postoperative course. Patients were followed up regularly for both functional and morphological outcome. • Success was defined as both symptomatic relief and radiographic resolution of obstruction at last follow‐up. RESULTS • Between 1998 and 2008, 526 cases of primary UPJO underwent open dismembered pyeloplasty at our centre. • Of these patients, 41 (8%) had UPJO with huge renal pelvis. • No perioperative complications were encountered in the study group. Mean (range) follow‐up was 34 (18–84) months and nine patients were lost to follow‐up. The overall success rate was 91%. • Two patients underwent redo pyeloplasty, whereas secondary nephrectomy was necessary in one. • Improvement of hydronephrosis was evident in all patients, except in three patients who underwent secondary procedures. • However, persistent obstruction on diuretic renography was seen in most cases (65%). CONCLUSIONS • Open pyeloplasty for huge pelvis UPJO is feasible with a high success rate. • Varying degrees of hydronephrosis and radiological obstruction after pyeloplasty are not uncommon. • Nephrectomy is rarely indicated in cases with severely deteriorated renal function.

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Section: Discussionmentioning

confidence: 99%

“…Some studies have reported on the effect of nephroplasty or nephroplication for reducing intrarenal dilatation and improving drainage [1–3]. Hemal et al .…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

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Long‐term functional and morphological outcome after pyeloplasty for huge renal pelvis

et al. 2010

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“…Hydronephrosis, which is defined as distension and dilation of the kidneys, is generally caused by obstruction to free flow of urine from the kidneys, such as ureteropelvic junction obstruction (UPJO). 1 Congenital UPJO serves as a prime indicator during the pathogenesis of hydronephrosis, which is an ailment that is twice as common in boys than in girls. 2 Moreover, hydronephrosis caused by UPJO can lead to progressive renal impairment and further renal failure if left untreated.…”

Section: Introductionmentioning

confidence: 99%

Use of double-J ureteric stents post-laparoscopic pyeloplasty to treat ureteropelvic junction obstruction in hydronephrosis for pediatric patients: a single-center experience

et al. 2020

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Objectives We aimed to investigate the safety concerns associated with placing double-J ureteric stents post-laparoscopic pyeloplasty surgery for congenital ureteropelvic junction obstruction (UPJO) and hydronephrosis. Methods A total of 1349 patients with postoperative double-J stent placement at our center were included. Clinical variables for enrolled patients were collected by two independent authors. We compared clinical variables and the efficacy of stenting post-laparoscopic pyeloplasty. Results The mean age of the patients was 4.23 ± 2.39 years. A total of 58.49% of patients were diagnosed with left UPJO with hydronephrosis and 33.95% were diagnosed with right UPJO. Furthermore, 7.56% of patients had bilateral UPJO. In all cases, 96.96% of indwelling double-J stents were successfully removed 4 weeks post-surgery. A total of 3.04% of the patients still required further management, including stent migration to the renal pelvis (0.37%), stent migration to the bladder (0.30%), prolapse of the stent through the ureter (0.15%), blockage of stents (1.85%), and fouling of stents (0.37%). Conclusions Double-J ureteric stents used after laparoscopic pyeloplasty for treating UPJO in hydronephrosis for pediatric patients is a safe, feasible, and beneficial method, which can be recommended for routine procedures. However, caution should be practiced for follow-up and removal using this method.

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Managing Stones: Unusual Anatomy in a Patient with UPJ Obstruction

Pathak

Hemal

2021

Techniques of Robotic Urinary Tract Reconstruction

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Laparoscopic nephroplication and nephropexy as an adjunct to pyeloplasty in UPJO with giant hydronephrosis

Cited by 7 publications

References 7 publications

Long‐term functional and morphological outcome after pyeloplasty for huge renal pelvis

Long‐term functional and morphological outcome after pyeloplasty for huge renal pelvis

Use of double-J ureteric stents post-laparoscopic pyeloplasty to treat ureteropelvic junction obstruction in hydronephrosis for pediatric patients: a single-center experience

Managing Stones: Unusual Anatomy in a Patient with UPJ Obstruction

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