Ureteroscopic holmium:YAG laser endopyelotomy is effective in distinctive ureteropelvic junction obstructions

Abstract

Aim: To evaluate the effectiveness and safety of holmium:YAG (Ho:YAG) laser endopyelotomy in distinctive ureteropelvicjunction obstructions (UPJO) with distinctive aetiologies.Thirty-one patients diagnosed with UPJO of distinctive causes were included. Aetiologyconsisted of 7 congenital UPJO, 10 post-pyeloplasty UPJO, 7 post-lithotomy obstructions, 4 ureteropelvic junctionobstructions post-extracorporeal shockwave lithotripsy stenoses and 3 post-ureteroscopic lithotriptic UPJO. Retrogradeureteroscopic Ho:YAG laser endopyelotomy was performed in all patients. Operation related parameters were studied.Average procedure duration was 46 min. Mean discharge was 1.81 days. There was no notable complicationsuch as perforation or haemorrhage. All patients were followed for at least 12 months. The single success rate was80.6%, leaving 6 patients undergoing secondary endopyelotomy, among whom 4 were successful while 2 requiredan open approach. The overall success rate was 93.5%. Failed pyeloplasty UPJO is more disposed to restenosis(p = 0.0075). Inversely implanted ureteral stent yielded a higher success rate (p = 0.0158).Ho:YAG laser endopyelotomy is a safe, minimally invasive approach effective in both primary and secondaryUPJO treatments. Implantation of inversed ureteral stents can be more beneficial.

Keywords

• ureteropelvic junction obstruction
• ureteroscopic
• endopyelotomy
• laser