Urology Resident City of Hope National Medical Center
Introduction: Anderson-Hynes dismembered pyeloplasty is the gold standard for ureteropelvic junction obstruction (UPJO). Recent trends in urologic reconstruction challenges the traditional transecting approach with increasing options for a non-transecting approach to include urethroplasties as well as ureteroneocystostomies. We aim to present our experience of performing a robotic non transecting pyeloplasty for UPJO with a crossing vessel.
Methods: We present an index case of a 23 year-old male who initially presented with right sided flank pain and was found to have right sided hydronephrosis with a crossing vessel. Patient underwent workup with nuclear medicine renal scan that showed no evidence of excretion from the right kidney with 20% function. Patient underwent non-transecting right robotic pyeloplasty with ureteral stent placement.
Results: Patient was seen in follow up for stent removal at 4 weeks post operatively. Follow up ultrasound one month after stent removal showed improved hydronephrosis. Patient had no flank pain post operatively.
Conclusions: While transecting pyeloplasty remains the gold standard for UPJO, robotic non-transecting pyeloplasty is a feasible option to help preserve vascular supply to the proximal ureter and renal pelvis.