6 Cases of Modified Dismembered Pyeloplasty in Hydronephrosis

Shin, Jung Hyen; Chin, GiI Nam

Abstract

The dismembered Foley Y-plasty and Anderson-Hynes pyeloplasty are in principle the same operation for the correction of hydronephrosis secondary to obstruction at ureteropelvic junction. The differences between the former and the letter are that Anderson used a downward and continuous 0000 suture for a watertight closure, while Foley proposed upward and interrupted 0000 sutures about 2mm. apart for accurate tissue approximation and minimal interference with wound margin blood supply. We used downward and interrupted 0000 suture so-called modified dismembered pyeloplasty as mixed type, with a use of nephrostomy and stenting in 6 cases of hydronephrosis secondary to ureteropelvic obstruction during the period from January, l978 to June, l979. They were observed for 6 to l8 months and the results were as follows: 1) Hydronephrosis secondary to ureteropelvic obstruction was caused by congenital stricture in 4 kidneys, aberrant vessel in 1 kidney and congenital stricture with aberrant vessel in 1 kidney. 2) Of 2 cases of aberrant vessel, one was cut and the other not cut because of ischemia of corresponding lower pole. 3) In all case, Ureteral stenting was done with nephrostomy. But complication, such as urinary 1eakage, did not occurred in any cases. 4) On the follow up, the result was fair in 1 case and good in others.