Conclusions: Laparoscopic pyeloplasty is becoming the treatment choice for UPJO
, but intracorporeal laparoscopic suturing and tissue handling remain a challenge to nonexperienced laparoscopic surgeons.
We have compared those that had surgery secondary to abnormal imaging, and had remained asymptomatic, to patients who underwent a pyeloplasty secondary to symptoms from their UPJO.
Population with symptomatic UPJO indications for surgery
The 5 patients who experienced previous resolution of their ANH presented back to their urologist with symptoms a mean 31 months after their last clinic appointment (and discharged from surveillance) with symptomatic UPJO (Fig.
21) Additionally, robot-assisted laparoscopic "reoperative" pyeloplasty in children with persistent UPJO after open surgical correction is also reported to be a safe and effective option in the treatment of these challenging cases.
Indication: Robotic-assisted ureterocalicostomy (RAUC) is a potential option in patients with UPJO and significant lower pole caliectasis, patients with failed pyeloplasty and a minimal pelvis, or patients with an exaggerated intrarenal pelvis.
2) The coexistence of trifid pelvis and UPJO is rare.
Delayed intravenous urography (IVU) revealed probable left UPJO and a dilated left pelvic system (Fig.
All pediatric patients with primary UPJO and with dilated renal pelvis were included.
The peritoneal incision was made along mezocolic line for left side UPJO.
We retrospectively reviewed the charts of 134 consecutive patients undergoing primary and secondary repair of UPJO through a dorsal lumbotomy approach by a single pediatric urologist from September 2002 to September 2008.
The diagnosis of UPJO has been firmly established clinically and radiologically by an ultrasound and/or a MAG-3 Lasix renogram prior to surgery.