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  • Title: Retrograde acucise endopyelotomy: is it worth its cost?
    Author: Sofras F, Livadas K, Alivizatos G, Deliveliotis Ch, Albanis S, Melekos M, Christoforidis K.
    Journal: J Endourol; 2004 Jun; 18(5):466-8. PubMed ID: 15253822.
    Abstract:
    PURPOSE: To identify patients with ureteropelvic junction (UPJ) obstruction who will benefit from endoscopic Acucise incision of the stenosis and to compare the open Hynes-Anderson pyeloplasty with this minimally invasive technique. PATIENTS AND METHODS: In a prospective trial, 22 patients with primary and secondary UPJ obstruction were treated by Acucise endopyelotomy, and 18 patients were treated by Hynes-Anderson pyeloplasty. Preoperative and postoperative renal scans were used to determine the degree of obstruction and intravenous urography, ultrasound scanning, or both to assess the degree of dilation. RESULTS: There was a vast difference in the cure rate of the two groups: Hynes-Anderson pyeloplasty cured 94.5% of the patients, while in the Acucise group, the cure rate was only 32%. There was some improvement in another 22% of the patients, but the renal scan curve remained obstructed. The remaining 45% of patients failed to show any improvement. CONCLUSION: Acucise endopyelotomy will improve or cure only patients with good renal function and mild dilation of the pelvicaliceal system. Patients with severe dilation should be treated by Hynes-Anderson pyeloplasty.
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