Pyeloplasty

The widespread use of ultrasonography during pregnancy has resulted in a higher detection rate for antenatal hydronephrosis. Ureteropelvic junction obstruction is the most common pathological cause of neonatal hydronephrosis. Surgical indications for this hydronephrosis comprise a decrease of split renal function (>5 %) on renography or increased dilatation on ultrasonography in subsequent studies, or existence symptoms such as breakthrough urinary tract infection or the abdominal pain during follow-up. The Anderson-Hynes dismembered method has been adopted most widely now. It is available in any cases with ureteropelvic junction obstruction due to intrinsic or extrinsic stenosis or high insertion. It is key point for the success of pyeloplasty to anastomose the apex of caudal angle of the renal pelvis and the crotch of the spatulated ureter with five sutures as knock stitch and come the funnel shape with the double pigtail stent finally. Remove the stent 2-3 months postoperatively under cystoscopy. Evaluate renal pelvic dilatation and split renal function 6 months postoperatively. Success pyeloplasty should be defined as no symptom, reduced pelvic dilatation, and stable or improved split renal function compared to preoperative condition.