Long-Term Results of Anderson-Hynes Pyeloplasty in 180 Adults in the Era of Endourologic Procedures

Abstract

Introduction: The aim of the present study wasto evaluate the long-term results of adult open pyeloplasties performed by the Anderson-Hynes technique in the era of new endourologic procedures. Materials and Methods: The medical records of 180 adult patients who underwent Anderson-Hynes pyeloplasty with a diagnosis of ureteropelvic junction (UPJ) obstruction, were retrospectively reviewed. Pre- and postoperative results were compared with clinical, radiologic and radionuclide studies. The mean age of the patients was 33.2 (16–65) years. The minimum clinical follow-up time was 12 months and the mean time from the operation was 9.4 years (between 1 and 17 years). Results: Success was defined as resolution of symptoms and decrease in pyelocaliceal volume and calicectasis. The overall success rate was 91.1%. The success rate was between 93.1 and 100% in patients with grades I–III and 62.5% in patients with grade IV hydronephrosis and contribute to renal function less than 25%. The pyelocaliceal volume returned to normal in 39 (21.7%) patients, significantly decreased in 82 (45.5%), and the flow of contrast media from renal pelvis to ureter improved in 43 (23.9%) and did not change or increased in 16 (8.9%). The failure happened in the first 3 months in 57% of patients and in long-term follow-up in 43% of patients. Conclusion: Despite newer endoscopic techniques, Anderson-Hynes pyeloplasty, with an over 90% success rate remains the gold standard in the treatment of primary UPJ obstruction.

Robotic-assisted laparoscopic pyeloplasty as management for recurrent ureteropelvic junction obstruction: a comparison study with primary pyeloplasty

“…Pyeloplasty, which was first described by Kuster and thereafter popularized by Anderson and Hynes, remains as the gold standard management of UPJO (1). The success rate of pyeloplasty was reported greater than 94% across open, laparoscopic and robotic-assisted approaches recently (2)(3)(4)(5). However, treatment is not standardized for failed cases that require additional interventions.…”

Anderson-Hynes pyeloplasty in children – long-term outcomes, how long follow up is necessary?

“…In foreign research literature, Madi presented 88% of good results after one year and 83% in further control [ 9 ]. Gogus shows dependence between the efficacy of the surgery and the level of dilation of the kidney pyelocalyceal system presenting from 25% to 100% (I–IV level of hydronephrosis) [ 10 ]. In the majority of research papers the effectiveness of surgery is assessed based on the lack of necessity of re-operation and on the regression of symptoms.…”

Pyeloplasty for pelviureteric obstruction junction obstruction

“…degree of hydronephrosis at presentation: 62.5% for grade 4 hydronephrosis vs 91.1% overall. 4 Other techniques include the following: 5 -Foley Y-V plasty -useful for high insertion of the ureter ( Figure 2 LP LP is considered (including robot-assisted surgery) the standard of care treatment for PUJO. 6 Since its introduction in 1993, LP has largely replaced OP because it can offer similar success rates while substantially reducing the morbidity of the large flank incision, prolonged pain and recovery associated with open access.…”