Open Pyeloplasty Surgical Techniques: Success Rate and Complications

Abstract

Analytic study for patient’s characteristics and open surgical techniques for patients diagnosed with PUJO in Benghazi, single center experience. A retrospective study of Forty-eight patients admitted to Al Hawari Urological Center in Benghazi diagnosed with UPJO during period of 36 months start from 1. 1. 2019 to 31. 12. 2021. 48 out of 132 with hydronephrosis cases [36.3%] were diagnosed as UPJO indicating that the UPJ obstruction constitutes the most common cause of hydronephrosis in our center. Clinical data regarding age, sex, complaint, laboratory investigations and KUB imaging studies, types of UPJO, side of UPJO, types of operations and post-operative complications were analysised and evaluated in our series. There were two common types of open operations which were Anderson-Hynes pyeloplasty [38 cases] and Y-V folly’s pyeloplasty [8 cases], the patients were discharged on 5th - 7th day post operatively. 58% of cases were adults, both gender were affected equally and the most common presentation war loin pain [56.2%] followed by UTI [18.7%] and accidental [12.5%]. The age ranged between 2 months -70 years. The condition was most common in left side 25 cases [52.08%],and 20 cases [41.6%] on the right and bilateral affection in 6.2. Success and failure rate of both procedures [94% - 75% respectively] and the post-operative complications (fever, heamaturia and urinary leak and their conservative management were reviewed). 38 cases subjected to Anderson Hynes pyeloplasty [79.1%], the successful rate was 36 cases [94.7%] and failed in 2 cases 5.3%. Folly’s repair was done in other patients with excluding 2 cases who missing the follow up. The successful rate was 6 cases [75%]. UPJO was not uncommon in our society. Open pyeloplasty still giving good results and good success rate and rare possibility of post operative minor complications. So, these practices should be encouraged. it is recommended that to early diagnose of congenital urogenital system anomalies particularly UPJO  antenatally is required to avoid complications.