The Y-V Pyeloplasty Revisited

Objectives: To present a new method of laparoscopic Y-V pyeloplasty to treating ureteropelvic junction (UPJ) stenoses in patients with enlarged renal pelvis. Y-V pyeloplasty for the correction of UPJ stenosis has become well known. Despite its simplicity and good anatomic and functional results, there is no reduction of renal pelvic size and thus Y-V pyeloplasty has not been recommended for treating UPJ stenoses in patients with enlarged renal pelvis. We present a new method of laparoscopic Y-V pyeloplasty that includes simultaneous reduction of the renal pelvis and may extend the use for this procedure. Methods: A Y-V pyeloplasty, modified by extending the cranial limbs of the Y-shaped incision in an elliptic manner to eliminate redundant pelvic tissue, was used to reduce a hydronephrotic pelvis while widening the UPJ. Results: Three women aged 20-60 years underwent surgery for UPJ with this technique. The postoperative course was uneventful. After 10-43 months of follow-up there has been no evidence of obstruction. Conclusions: The herein described modification allows extending the use of Y-V pyeloplasty to UPJ stenosis with enlarged renal pelvis.