Estenosis ureteropiélica, tratamiento quirúrgico

introduction: currently there are many therapeutic options for ureteropelvic junction obstruction (upjo). open pyeloplasty is the gold standard with a success rafe of approximately 90%. we describe our experience in the treahent of upjo. material and methods: we conducted a retrospective and descriptive study among our patients with upjo surgically treated at the department of urology of our institution from 1970 to 2002. results: 126 upjo were diagnosed in 114 patients. the most common symptoms at diagnosis were: pain in 105 patients (92.1). urinary tract infection (uti) in 37 (32.4%) and hematuria in 24 (21 %). the most common associated diseases were urolithiasis in 34 cases, crossing vessels in 10 and horseshoe kidney in 5. 123 procedures were undertaken: 92 (74.8%) dismembered pyeloplasties, 13 (10.7%) foley y-v pyeloplasties, in 8 (6.5%) release of crossing vessel, 5 (4%) endopyelotomies, 2 (1.6%) pyeloplasties scardino-prince, 2 patients with renal allograft in whom an anastomosis of renal pelvis to native ureter was performed and 1 (0.8%) ureter-ileal anastomosis in a patient with retroperitoneal fibrosis. the mean follow-up time was of 33.2 months. in 114 (92.7%)patients the procedure was successful. the overall complication rate was of 17.9% of which 2.4% were stricture recurrence associated with crossing vessels. conclusion: open dismembered pyeloplasty is the most common treatment procedure for upjo at our institution. we report successful results, low morbidity, preservation of renal function and improving symptoms.