Antegrade Transpelvic Endopyelotomy in Primary Obstruction of the Ureteropelvic Junction

The authors present a 5-year follow-up of endopyelotomy using a personal technique for cases of primary ureteropelvic junction obstruction. After percutaneous access has been gained via a lower calix, the technique involves wide opening of the renal pelvis and exploration of the peripelvic space before a 3- to 4-cm long sectioning of the ureter. The aim is to carry out all of the operation in full view and without the need for a large-caliber stent, in order to perform endopyelotomy also in pediatric patients or in presence of anomalous vessels. The follow-up demonstrates a good result in 80% of 46 patients aged 5 to 62 years; two patients underwent surgical repair. The authors think the antegrade transpelvic endopyelotomy is an endourologic operation whose results and feasibility parallel those of open surgery.