Aim: To present the results of a new modification of dismembered pyeloplasty performed to prevent the occurrence of secondary obstruction. Methods: Modified dismembered pyeloplasty was performed in 35 children (age range 3 months to 16 years) who had unilateral ureteropelvic junction obstruction. In postoperative follow-up, presence of hydronephrosis on ultrasonography, differential renal function (DRF) and renal drainage half-time on technetium-99m diethylenetriaminepentaacetic acid (DTPA) renography were recorded and compared with preoperative data. Results: Mean anteroposterior renal pelvic diameter, mean preoperative DRF and radioisotope clearance half-time on DTPA renography of the affected kidneys were 61.4 mm, 38.6% and 34.3 min in children with prenatal hydronephrosis, and 67.5 mm, 37.6% and 39.4 min in children that presented with symptoms, respectively. After surgery, mean anteroposterior renal pelvic diameter, mean DRF and radioisotope clearance half-time on DTPA renography of the affected kidneys were 10.9 mm, 45.9% and 11.9 min in children with prenatal hydronephrosis, and 20 mm, 41.9% and 15.2 min in children that presented with symptoms, respectively. No failure was observed in any patient at an average follow-up of 26 months (range 1–5 years). Conclusions: Open dismembered pyeloplasty is the treatment of choice for intrinsic ureteropelvic junction obstruction. The modification of dismembered pyeloplasty that we performed is an alternative for the prevention of secondary obstruction.

Keywords:
Hydronephrosis, Ureteropelvic junction obstruction, Pyeloplasty
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© 2008 S. Karger AG, Basel
2007
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