Evaluation of the Efficacy of Laparoscopic Pyeloplasty in Adult Patients

Objective The aim of our study was to evaluate the outcomes of the laparoscopic pyeloplasty and to report our experience in this procedure. Methods A total of 23 patients, who underwent a laparoscopic pyeloplasty due to ureteropelvic junction obstruction, between January 2020 and December 2024, in two tertiary care centers, were enrolled in this retrospective study. The durations of the operations, postoperative hospital stays, pre/postoperative renal function values, pre/postoperative estimated glomerular filtration rates (eGFR), pre/postoperative (3rd month) differential renal functions, and t ½ values according to the Tc‐99m mercapto acetyl triglycine (MAG3) renogram and follow‐up times were recorded. Results A total of 23 patients, whose ages ranged from 16 to 48 years (mean age 31.4 ± 7 years) were included in the study. Of those, 8 were male and 15 were female. The mean follow‐up time was 22.1 ± 11.8 (6–60) months. Preoperative and postoperative eGFR values were 105 ± 14.2 and 110.8 ± 11.5, respectively, and the increase was statistically significant ( p < 0.05). According to the Tc‐99m MAG‐3 renogram, preoperative and postoperative mean renal functions were 31.5 ± 5.4% and 34.6 ± 5.6%, respectively, and the increase was statistically significant ( p < 0.05). In addition, according to the Tc‐99m MAG‐3 renogram of the patients, preoperative and postoperative mean t ½ values were 26.3 ± 15.7 min and 15.5 ± 7.6 min, respectively, and the decrease was statistically significant ( p < 0.05). Only Grade 1 ( n = 7, 30%) and Grade 3a ( n = 2, 9%) complications were encountered. The patients were grouped as “successful” ( n = 20) and “unsuccessful” ( n = 3), (Group 1 and Group 2, respectively). Among the parameters showing the renal function, postoperative Tc‐99m MAG3 scintigraphy t ½ was significantly higher in Group 2 ( p < 0.05). Conclusion Laparoscopic transperitoneal pyeloplasty achieved an 87% success rate and showed significant improvement in renal drainage.