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Definitive Management of Failure After Pyeloplasty.

Publication ,  Journal Article
Swearingen, R; Ambani, S; Faerber, GJ; Bloom, DA; Wolf, JS
Published in: J Endourol
May 2016

INTRODUCTION: Failure after pyeloplasty is difficult to manage. We report our experience managing pyeloplasty failures. METHODS: We retrospectively reviewed the case log of a single surgeon, from August 1996 to August 2014, to identify all patients undergoing a surgical procedure after failed pyeloplasty. We excluded patients without follow-up exceeding 1 year from initial postpyeloplasty procedure. Failure was defined as a need for additional definitive intervention. RESULTS: Of 247 laparoscopic pyeloplasties, 68 endopyelotomies and 305 simple laparoscopic nephrectomies reviewed, 41 were performed after previous pyeloplasty and had sufficient follow-up. Laparoscopic nephrectomy was performed in nine patients. All three secondary laparoscopic pyeloplasties were successful. Of 29 secondary endopyelotomies, 10 (34%) were successful. Of the 19 failures after secondary endopyelotomy, 12 patients had tertiary pyeloplasty (5 laparoscopic and 7 open surgical), 5 (26%) underwent tertiary endopyelotomy, and 2 (11%) required nephrectomy. Our overall endopyelotomy success rate was 38% (13/34) vs 100% (11/11) for secondary or tertiary pyeloplasty (4 patients lost to follow-up). Median time to failure was 5 months for endopyelotomy. Median follow-up for patients free from intervention was 40.2 months. CONCLUSIONS: Secondary pyeloplasty (including both laparoscopic and open surgical approach) is more than twice as successful as endopyelotomy after failed pyeloplasty. Secondary pyeloplasty is an excellent alternative to endopyelotomy in select patients with failure after initial pyeloplasty.

Duke Scholars

Published In

J Endourol

DOI

EISSN

1557-900X

Publication Date

May 2016

Volume

30 Suppl 1

Start / End Page

S23 / S27

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Ureteral Obstruction
  • Ureter
  • Treatment Failure
  • Retrospective Studies
  • Reoperation
  • Postoperative Complications
  • Male
  • Laparoscopy
  • Kidney Pelvis
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Swearingen, R., Ambani, S., Faerber, G. J., Bloom, D. A., & Wolf, J. S. (2016). Definitive Management of Failure After Pyeloplasty. J Endourol, 30 Suppl 1, S23–S27. https://doi.org/10.1089/end.2015.0837
Swearingen, Ryan, Sapan Ambani, Gary J. Faerber, David A. Bloom, and J Stuart Wolf. “Definitive Management of Failure After Pyeloplasty.J Endourol 30 Suppl 1 (May 2016): S23–27. https://doi.org/10.1089/end.2015.0837.
Swearingen R, Ambani S, Faerber GJ, Bloom DA, Wolf JS. Definitive Management of Failure After Pyeloplasty. J Endourol. 2016 May;30 Suppl 1:S23–7.
Swearingen, Ryan, et al. “Definitive Management of Failure After Pyeloplasty.J Endourol, vol. 30 Suppl 1, May 2016, pp. S23–27. Pubmed, doi:10.1089/end.2015.0837.
Swearingen R, Ambani S, Faerber GJ, Bloom DA, Wolf JS. Definitive Management of Failure After Pyeloplasty. J Endourol. 2016 May;30 Suppl 1:S23–S27.
Journal cover image

Published In

J Endourol

DOI

EISSN

1557-900X

Publication Date

May 2016

Volume

30 Suppl 1

Start / End Page

S23 / S27

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Ureteral Obstruction
  • Ureter
  • Treatment Failure
  • Retrospective Studies
  • Reoperation
  • Postoperative Complications
  • Male
  • Laparoscopy
  • Kidney Pelvis