Category: Laparoscopic/ Robotic: Other

MP14-22 - Retroperitoneoscopic pyeloplasty for primary UPJ obstruction in Horseshoe kidney: Experience of a tertiary care centre from Nothern India

Sat, Sep 22
10:00 AM - 12:00 PM

Introduction & Objective : Primary UPJ obstruction (UPJO) is seen in 30% Cases of Horseshoe kidney. Retroperitoneoscopic pyeloplasty is  less reported for surgical management of UPJO in such cases. We report our experience of performing classical retroperitoneoscopic pyeloplasty in 6 cases in  Horseshoe kidney


Methods : Between 2013 to 2017  six  cases of horseshoe kidney with unilateral  primary UPJO were operated by retroperitoneoscopy. The mean age was 18 years and all were male.  Left to right ratio was  4:2. Pain was the predominant symptom.  Ultrasound (USG) kidney, ureter and bladder (KUB)  and contrast CT Scan KUB were performed in all cases revealed findings suggestive of primary UPJO. DTPA  renal scan revealed obstructed system in all cases. Classical retroperitoneoscopic  dismembered pyeloplasty was performed  over a 6 F/26 cm  DJ stent all cases with 3 port technique. The DJR was performed after 6 weeks. A renal USG and DTPA scan at 2 weeks   following stent removal  were performed in all cases.


Results :

Total six cases were operated and mean operative time was  150±30 minutes. The mean blood loss was 75± 20 ml, mean tramadol requirement for pain control during hospital stay was  125±25 mg. The mean hospital stay was 2 days. No immediate postoperative complication occurred.  The success rate of pyeloplasty is  100% till last follow-up.  None of the patient developed any long term complication in mean follow-up of 36 months.


Conclusions :

The classical retroperitoneoscopic pyeloplasty for  primary UPJ obstruction shows excellent surgical outcome with  no complication in long term follow-up.

Vishwajeet Singh

Professor
Department of Urology, King George's Medical University, Lucknow, INDIA
Lucknow, Uttar Pradesh, India

Siddharth Pandey

Senior Resident
Department of Urology, King George's Medical University, Lucknow, INDIA
Lucknow, Uttar Pradesh, India

Rahul J. Sinha

Associate Professor
Department of Urology, King George's Medical University, Lucknow, INDIA
Lucknow, Uttar Pradesh, India

Ajay Aggarwal

Senior Resident
Department of Urology, King George's Medical University, Lucknow, INDIA
Lucknow, Uttar Pradesh, India