Laparoscopic approach to ureteropelvic junction obstruction in a bifid pelvis - Abstract

OBJECTIVE: About 10% of renal pelvis are bifids and not so there is a larger index of kidney disease over the normal pelves. The laparoscopy and minimally invasive techniques treat the ureteropelvic junction disease in a low agressive manner. We showed a video of an atypical pyeloplasty of ureteropelvic junction obstruction of a lower unit. The patient is a 33 year-old woman with an intermitent lumbar pain for 3 years. Your image exams showed a bifid left pelvis with a stenosis of the lower unit. We chose to do the fix of this pathology laparoscopically.

MATERIALS AND METHODS: We positioned the patient in a right lateral decubitus and 3 trocars was placed, we identify the obstructed junction and a terminolateral anastomosis was performed.

RESULTS: The procedure lasted 95 minutes, with little blood loss and the patient was discharged in 2 days. We withdraw the double J catheter after 1 month, a pyelography and a ureteroscopy was performed which showed a pervious anastomosis. After 2 months of follow-up the patient is doing well.

CONCLUSIONS: As far as we know, this is the first case of literature with correction by laparoscopy. The stenosis of ureteropelvic junction in the lower unit of a bifid pelvis can be corrected effectively by laparoscopic surgery.

Written by:
Curcio L1, Ahouagi AC, Renteria J, Araujo IR, Presto D   Are you the author?
1Ipanema General Hospital, Rio de Janeiro, Brazil.

Reference: Int Braz J Urol. 2013 May-Jun;39(3):438; discussion 439
doi: 10.1590/S1677-5538.IBJU.2013.03.20

PubMed Abstract
PMID: 23849578 Endourology Section