Surgical Outcome of Tubeless Dismembered Pyeloplasty in Adult Ureteropelvic Junction Obstruction and Significance of Double-J Ureteral Stenting

Boo, Myung Seop; Choi, Ho Cheol; Choi, Sung Hyup

Abstract

PURPOSE: The decision of whether to intubate or not remains largely a matter of individual preference. At our university, we routinely performed tubeless dismembered pyeloplasty and reverse intubated repair only when concomitant pathological conditions dictate intubation. We review our experiences with tubeless pyeloplasty during the last 12 years and evaluate the necessity of intraoperative double-J ureteral stenting. MATERIAL AND METHODS: From January 1985 to January 1996, adults with 49 renal units underwent tubeless dismembered Anderson-Hynes pyeloplasty at our university hospital.
RESULTS
Markedly dilated renal pelvis was reduced surgically in 17 renal units (34.6%, reduction pyeloplasty). The success rate of tubeless pyeloplasty was 89.7% (44/49 renal units). In failed 5 renal units, 4 renal units with postoperative persistent urine leakage were managed using a retrograde insertion of Double-J ureteral stent at outpatient basis (8.2%) and 1 renal units with persistent ureteral stricture despite of redo pyeloplasty was removed surgically (2.0%).
CONCLUSION
The success rate of our experience (89.7%) was relatively lower than others with intubated pyeloplasty because of persistent urine leakage and ureteral stricture. Urine leakage can be reduced with intraoperative placement of Double-J ureteral stent. Double-J ureteral stent can be easily removed in the outpatient department with minimal complication. Therefore, we would like to recommend the intraoperative placement of Double-J ureteral stent during the adult dismembered pyeloplasty.