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Management of ureteropelvic junction obstruction using a microsurgical technique.

The use of microsurgery in the treatment of 20 patients with ureteropelvic junction obstruction is described. The Culp-DeWeerd vertical flap pyeloplasty and the dismembered Anderson-Hynes technique were modified by means of microsurgical instruments, optical magnification and fine absorbable polyglactine sutures, described in detail and used in 11 and 8 cases, respectively. In a further patient a similar modified Kucera pyeloplasty was performed. The advantages of the application of microsurgical technique in reconstructive surgery of the renal pelvis and the ureter are the following: no routine use of urinary diversion; shorter hospitalization time; higher success rate, and a cost-saving therapy.