Paper Information

Title: 

COLD URETEROSCOPIC INSICION IN URETERO-PELVIC JUNCTION STENOSIS TREATMENT

Type: PAPER
Author(s): GEAVELETE P.,SYED AGHAMIRI -*,MIRCIULESCU V.,NITA GH.,GEORGESCU D.
 
 *
 
Name of Seminar: CONGREH ANJOMAN UROLOGY IRAN
Type of Seminar:  CONGRESS
Sponsor:  ANJOMAN OROLOGY
Date:  2005Volume 8
 
 
Abstract: 

INTRODUCTION URETERO-PELVIC JUNCTION (UPJ) OBSTRUCTION CAN BE TREATED BY VARIOUS MODALITIES: "STANDARD" OPENED SURGERY, PERCUTANEOUS PROCEDURES, VARIOUS RETROGRADE URETEROSCOPIC TECHNIQUES, LAPAROSCOPIC APPROACH, ETC. OUR OBJECTIVE WAS TO ESTABLISH MINIMALLY INVASIVE TREATMENT ALTERNATIVE OF UPJ OBSTRUCTION.
METHODS BETWEEN NOVEMBER 1997 AND FEBRUARY 2003 WE PERFORMED 71 COLD END INCISION IN UPJO WITH III-RD GRADE HYDRONEPHROSIS (CONGENITAL OBSTRUCTION–31 CASES AND POSTOPERATIVE RECURRENCES–40 CASES). THE UPJO SERIES OF CASES WAS CHARACTERIZED BY: YOUNG PATIENTS, ABSENCE OF RENAL CALCULI, ABSENCE OF CROSSING RENAL VESSELS, ABSENCE OF MASSIVE HYDRONEPHROSIS AND ABSENCE OF HIGH URETEROPYELIC IMPLANTATION. WE USED RIGID ENDOSCOPIC EQUIPMENT (7.5 FRENCH) AND COLD KNIFE/SCISSORS ENDOINCISION TOOL. THE INCISION WAS MADE UNDER VIDEO ASSISTANCE AND FLUOROSCOPY, UNTIL THE PERIURETEROPYELIC FAT WAS LARGELY AND CLEARLY EXPOSED. THE PYELOSTENT (8/12 F) WAS REMOVED AFTER 8 WEEKS.
RESULTS WE REGISTERED A SUCCESS RATE OF 81.7% (58 CASES). ESPECIALLY DDU AND IVP REALIZED THE CONTROL EVALUATION. WE DIDN’T DESCRIBE MAJOR COMPLICATIONS (IN 11 CASES WE COAGULATED SMALL VESSELS). WE DESCRIBED IN 48 CASES (67.7%) NORMAL PYELOCALICEAL SYSTEM WITH LARGE PYELOURETERAL PASSAGE; IN 10 CASES (14%) AN IMPORTANT REDUCTION OF THE HYDRONEPHROSIS DEGREE WITH NORMAL PYELOURETERAL JUNCTION; IN 13 CASES (18.3%) NO CHANGES OF THE HYDRONEPHROSIS DEGREE OR WITH A RECURRENCE OF THE UPJO. THE BEST RESULTS WERE OBTAINED IN THE TREATMENT OF POSTOPERATIVE RECURRENCES.37 OF 40 CASES (92.5%) WITH NORMAL PYELOURETERAL JUNCTION. THE MEAN FOLLOW-UP PERIOD WAS 38 MONTHS (5 TO 59 MONTHS).
CONCLUSION IN ERE MAY REPRESENT AN EFFICIENT TECHNIQUE IN UPJ STENOSIS MINIMALLY INVASIVE APPROACH, WITH A REDUCED RATE OF COMPLICATIONS, SHORT PERIOD OF HOSPITALIZATION AND GOOD ANATOMICAL AND FUNCTIONAL RESULTS.

 
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