Comparison of percutaneous endopyelotomy with open pyeloplasty for pediatric ureteropelvic junction obstruction.

Abstract

Percutaneous endopyelotomy has been shown to be effective in the management of ureteropelvic junction obstruction in adults and secondary ureteropelvic junction obstruction in children. There are little published data regarding endopyelotomy as a primary treatment in children. During 3 years we performed 8 endopyelotomies and 20 open pyeloplasties for primary ureteropelvic junction obstruction and compared the results. Preoperative ureteropelvic junction obstruction was detected by renal ultrasound, excretory urogram (IVP) or renal scan. All patients were followed 1.5 to 3 years postoperatively. The success of the procedure was determined by excretory urogram, renal scan or the absence of clinical findings, with 1 failure in each group. The overall success rates for endopyelotomy and open pyeloplasty were 88% and 93%, respectively. Hospital stays were essentially equal between the groups but operative time and hospital costs were higher for endopyelotomy. Endopyelotomy may be performed effectively for primary ureteropelvic junction obstruction in children but with increased costs.