Early results of a new open surgical technique for treatment of uretero-pelvic junction obstruction

Objective: Here we report our initial experience with a new open surgical technique for treating uretero-pelvic junction obstruction (UPJO). Methods: One centimeter distal to the site of the uretero-pelvic junction (UPJ) stenosis, a longitudinal incision of about 15 mm was made over the lateral side of the ureter. The renal pelvis was evacuated. Simultaneously, an oblique incision was made over the posterior and anterior walls of the renal pelvis. The most dependent point over the renal pelvis was sutured to the distal end of the ureterotomy incision. The anterior edge of the pyelotomy incision was anastomosed to the anterior edge of the ureterotomy incision and the posterior edge was anastomosed to the posterior edge of the ureterotomy incision. When the pyeloplasty was completed, the UPJ, accompanied by the proximal 1 cm of the ureter and excessive parts of the renal pelvis, was excised. Results: In 21 (92%) out of 23 patients, the surgical technique was successful. Conclusions: This technique results in predictably good outcomes and has the advantages of the dismembered method. It seems to be a valuable alternative treatment for UPJO.