Long term results of pyeloplasty in adults

OBJECTIVE: To determine the presenting symptoms, complications, stone coincidence in the adult patients with primary ureteropelvic junction (UPJ) obstruction seen at King Abdul-Aziz University Hospital, (KAUH) Jeddah, Kingdom of Saudi Arabia, we are also reporting the success rate and long term results of adult pyeloplasty.

METHODS: We reviewed the records of 34 patients who underwent 37 pyeloplasty operations during the period January 1992 through to June 2002. The preoperative radiological diagnosis made by intravenous urogram (IVU) or renal isotopes scan. We excluded from our study patients with previous history of passage of stones, renal or ureteral surgeries, large renal pelvis stone that may cause UPJ obstruction, or abnormalities that may lead to secondary UPJ obstruction such as vesicoureteral reflux.

RESULTS: There were 26 male patients and 8 females, their age varied between 16 and 51-years, the mean age was 36.1-years, and 18 (52.9%) patients had concomitant renal stones. Ipsilateral split renal function improved by 3-7% post pyeloplasty in 23 patients, while in one patient the function stayed the same, and in another patient the split function reduced by 4%. T1/2 renal isotopes washout time became less than 15 minutes in 19 patients and less than 20 minutes in 6 patients. Intravenous urogram revealed disappearance of the obstruction at UPJ in 7 patients, while in 2 patients it became poorly functioning.

CONCLUSION: Anderson Hynes pyeloplasty is an excellent procedure for treating UPJ obstruction in adults. Our success rate is comparable to the international reported rates, while our study revealed a higher incidence of concomitant renal stones than the international studies.