Endourological treatment of ureteropelvic obstruction using holmium yag laser

Background: Ureteropelvic junction obstruction (UPJO) is defined as an impairment of urine outflow from the pelvis to the ureter. Several treatment approaches are in use. Objectives: To present the different endo-urological approaches - retrograde and antegrade techniques - for UPJO using the holmium: YAG laser. Methods: We followed 67 patients who underwent endopyelotomy between 1994-1997 and compared the different approaches for the treatment of UPJO. Results: A total of 67 patients were operated, 52 patients using retrograde approach and 15 using antegrade approach. In the retrograde approach success was achieved in 48 patients (93%) and in 14 patients (94%) in the antegrade approach. Complications rate was 10% and 40%, respectively. Hospital stay was 2.2 days in the retrograde approach and 4.6 in the antegrade approach. Conclusions: The success rate in the different endourologic approaches was high and no difference between the two approaches was identified. From our experience, lower complication rate and shorter hospital stay make the retrograde approach more advantageous.