Abstract
Background
: Endopyelotomy is a minimally invasive surgical alternative for primary ureteropelvic junction (UPJ) obstruction. However, its success in poorly functioning kidneys is controversial.
Patients and Methods
: In this retrospective study, 34 endopyelotomies performed on poorly functioning kidneys between January 1993 and December 1997 were reviewed. Of these, 13 patients had a glomerular filtration rate (GFR) <15 mL/min (Group I) and 21 had a GFR of 15 to 25 mL/min (Group II). All the patients insisted on endopyelotomy to avoid open surgery. Antegrade endopyelotomy was performed by the twin guidewire rail technique with a cold knife. An indwelling stent was kept for 2 to 6 weeks. Patients were followed up with assessment of symptoms and diuretic renograms at 3, 6, and 12 months postoperatively.
Results
: Endopyelotomy was considered successful in 8 of 13 patients (62%) in Group I. Success was achieved in 19 of 21 patients (90%) in Group II.
Conclusion
: Endopyelotomy can be performed for improvement of symptoms. Stabilization or improvement in GFR is less pronounced in poorly functioning kidneys with primary UPJ obstruction.
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