Received 24 June 2009; accepted 26 August 2009. published online 16 November 2009.
Objectives
To present a new method of laparoscopic Y-V pyeloplasty to treating ureteropelvic junction (UPJ) stenoses in patients with enlarged renal pelvis. Y-V pyeloplasty for the correction of UPJ stenosis has become well known. Despite its simplicity and good anatomic and functional results, there is no reduction of renal pelvic size and thus Y-V pyeloplasty has not been recommended for treating UPJ stenoses in patients with enlarged renal pelvis. We present a new method of laparoscopic Y-V pyeloplasty that includes simultaneous reduction of the renal pelvis and may extend the use for this procedure.
Methods
A Y-V pyeloplasty, modified by extending the cranial limbs of the Y-shaped incision in an elliptic manner to eliminate redundant pelvic tissue, was used to reduce a hydronephrotic pelvis while widening the UPJ.
Results
Three women aged 20-60 years underwent surgery for UPJ with this technique. The postoperative course was uneventful. After 10-43 months of follow-up there has been no evidence of obstruction.
Conclusions
The herein described modification allows extending the use of Y-V pyeloplasty to UPJ stenosis with enlarged renal pelvis.
Department of Urologic Surgery, The E. Wolfson Medical Center, Holon, Israel; and The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Reprint requests: Tsivian Alexander, M.D., Department of Urologic Surgery, The E. Wolfson Medical Center, PO Box 5, Holon 58100, Israel
Matvey Tsivian's current address is Division of Urology, Department of Surgery, Duke University Medical Center, Durham, North Carolina.
ABSTRACT