Laparoscopic ureteropelvic junction decompression for the management of obstruction.

INTRODUCTION We reported the outcome and complications of laparoscopic aberrant vessels transposition without performing pyeloplasty in patients with ureteropelvic stenosis. MATERIALS AND METHODS A total of 10 patients with ureteropelvic stenosis accompanying with aberrant vessels underwent laparoscopic transposition of vessels between June 2001 and March 2003. 4 of the cases were male and 6 were female, and 4 out of 10 had right side and 6 had left side involvement. The mean age was 31.9 (14 - 59). Reaction of aberrant vessels was performed by cutting the vain and fixing the artery to the lipid layer around the kidney and renal pelvis. RESULTS The procedure was successful in all the cases without any perioperative complications. The operative time was 2.20 hours (1.45 - 2.50) including cystoscopy, DJ placement, and transposition. Mean hospital stay was 2.9 (2-5) days, and patients were followed up an average of 9.1 (3-22) months. Except one case of rehospitalization due to pain, no complication occurred. The rate of clinical and radiological improvement was 100% and IVP showed a decrease in the degree of hydronephrosis as well as the resolution of obstruction observed in renogram. CONCLUSION With regard to our findings, it seems, at least in a proportion of patients with UPJ stenosis accompanied with crossing vessels, that mechanical compression is the mere cause of obstruction and primary stenosis does not coexist. As a result, treatment is achieved by transposition of the crossing vessels without entering the renal unit.