Dismembered Laparoscopic Anderson-Hynes Pyeloplasty Versus Nondismembered Laparoscopic Y-V Pyeloplasty in the Treatment of Patients with Primary Ureteropelvic Junction Obstruction: A Prospective Study

Purpose: An attempt has been made to prospectively compare the results of two laparoscopic pyeloplasties: Dismembered Anderson-Hynes (A-H) plasty and nondismembered Y-V plasty. Complications following the procedures have been studied as well. Patients and Methods: Fifty patients with primary ureteropelvic junction obstruction (UPJO) were prospectively selected at random to undergo dismembered A-H (25 patients-even numbers) and nondismembered Y-V (25 patients-odd numbers) laparoscopic pyeloplasty. UPJO was diagnosed on the basis of ultrasonography, excretory urography, and diuretic renography (DR). The intensity of pain was assessed according to a visual analog pain scale (VAS). Success was defined by three factors taken collectively: 80% or greater pain relief in comparison with the preoperative VAS score, no obstruction on DR (decreasing renographic excretion curve, T-1/2 <12 min), and improved or stable differential renal function. The mean follow-up was 26.2 months for the A-H group and 26.6 months for Y-V group (P = 0.865). Results: Both groups were comparable in terms of preoperative data, except for the presence of the crossing vessel, which was more often observed in the Y-V group. No statistically significant differences between the studied groups were found in operative times, morbidity, and hospitalization length. The success rate in the A-H group was 95% and 86% in the Y-V group, the difference being not statistically significant. Conclusions: Laparoscopic A-H pyeloplasty achieved a higher success rate then Y-V pyeloplasty; however, the difference was not statistically significant.