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Year : 2004  |  Volume : 20  |  Issue : 2  |  Page : 144-147

Ureterocalycostomy: A salvage procedure for complex ureteropelvic junction strictures

Department of Urology and Kidney Transplantation, Institute of Kidney Diseases and Transplantation Sciences, BJ Medical College and Civil Hospital Campus, Ahmedabad, India

Correspondence Address:
Tejanshu P Shah
65-B, Swastik Society, Navrangpura, Ahmedabad - 380 009
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Source of Support: None, Conflict of Interest: None

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Objectives: To report our experience with Ureterocaly­costomy for treating complex ureteropelvic junction stric­tures, to salvage a renal unit. Methods: Twenty-five patients were subjected to ure­terocalycostomy between year 1992 and 2002. Nineteen patients had UPJ obstruction; 7 had primary UPJ obstruc­tion with 3 having horseshoe anomaly and 4 having intrarenal pelvis, while 12 had secondary UPJ obstruc­tion following pyeloplasty (5), endopyelotomy (2) and pyelolithotomy (5). Six patients had long proximal ureteric strictures; 5 tuberculous and 1 following blunt abdominal trauma. Five patients had solitary units. Preliminary nephrostomy drainage was provided in all secondary cases and in solitary units. A wide spatulated anastomosis was performed after amputating lower pole parenchyma and further length was achieved by renal descensus in indi­cated cases. Results: Follow-up evaluation included ultrasonogra­phy, intravenous urography and renal scan. Twenty two patients improved and are still doing well. Two patients failed to show radiographic improvement although being asymptomatic. One patient presented with restricture and pyonephrosis and warranted nephrectomy. Conclusions: Ureterocalycostomy is a viable alterna­tive for salvaging a renal unit jeopardized by complex UPJ strictures. This procedure is a versatile one which can be done without any extra preparation even in unexpected situations.

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