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Laparoscopic pyeloplasty: the standard of care for ureteropelvic junction obstruction.

Open pyeloplasty has been the gold standard treatment for ureteropelvic junction obstruction (UPJO). Endopyelotomy, in spite of its inferior effectiveness, was sometimes preferred in select patients owing to its less invasive nature. Fortunately, over the past 2 decades a superior minimally invasive treatment has emerged with success rates equivalent to open pyeloplasty and complication rates equivalent to endopyelotomy. It is for good reason that laparoscopic pyeloplasty has become the new standard of care for the treatment of UPJO. 
 
Ureteropelvic junction obstruction is marked by renal outflow obstruction and may be asymptomatic or result in pain and complications, such as renal failure, pyelonephritis and calculus formation. Surgical management of UPJO aims to provide symptomatic relief and preserve remaining renal function. Today, treatment usually consists of either laparoscopic pyeloplasty or endopyelotomy. Its effectiveness, versatility and safety make laparoscopic pyeloplasty the optimal treatment for UPJO in virtually all circumstances.