Partial-tickness-endopyelotomy for failed pyeloplasty after open pyeloplasty and factors effecting the success rate

Objectives: To detect the success rates of partial-tickness-endopyelotomies after failed pyeloplasty and factors affecting these success rates. Materials and Methods: Between 2007 and 2017, 12 patients had partial-tickness-endopyelotomy after failed pyeloplasty. We analyzed the post operational 1-year results. Endopyelotomy was applied without reaching the peri-ureteral fat tissue (partial-tickness-endopyelotomy). A JJ catheter was applied for all patients at the end of all procedures. Total and partial symptomatic relief symptomatic was defined as success, and no improvement in symptoms was defined as failure. Results: There were 7 (58.3%) males and 5 (42,7%) females. Seven (58.3%) patients had right sided uretero-pelvic stenosis(UPS), and 5 (42,7%) patients had left sided UPS. Patients mean age was 29.3(20-43). The mean time after first operation was 2.22(0.25-13) years. All patients had pain at related side. Ten(83.3%) (2 missing) patients had obstruction at IVP; 3(25%) had grade 2, 5(41.7%) had grade 3, and 2(16.7%) had grade 4 hydonephrosis at USG(2 missing); 11(91.7%)(1 missing) didn’t have respond to IV diuretic at DTPA renal Scintigraphy. After operations 5(58.3%) patients had obstruction at IVP (p=0.564); 1(8.3%) had no hydronephrosis, 1(8.3%) had grade 2, 6(50%) had grade 3, at USG(4 missing) (p=0.04); and 8(66.7%) didn’t have respond to IV diuretic at DTPA renal Scintigraphy (2 missing) (p=0.058). Six patients had failure(50%) , and 6(50%) patients had success (p=0.004). Time lag from first operation was detected to be the most valuable factor for success. Conclusions: Partial-tickness-endopyelotomy provided some symptomatic relief during 1-year follow up. This technique could be used to avoid periureteral complications