Efficacy of retrograde endopyelotomy in children.

Abstract

Endopyelotomy has been performed extensively in adults for the treatment of ureteropelvic junction obstruction. To determine its applicability to the pediatric population we reviewed our experience with retrograde endopyelotomy in children. Eight children 4 to 15 years old were treated with retrograde endopyelotomy and results were compared to those of a concurrent group of 8 treated with open pyeloureteroplasty. Retrograde endopyelotomy was done in all of our patients with lower ureteral dilatation (as an adjunct measure in 5). Seven patients had symptomatic and radiographic improvement. The patient in whom the procedure failed had a crossing lower pole vessel. Postoperative analgesia, length of hospitalization and cost were lower in the endopyelotomy group. Retrograde endopyelotomy is feasible in children older than age 4 years and it results in reduced morbidity. The success rate is high but open surgery remains the standard, particularly when a crossing lower pole vessel is identified preoperatively.