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<p>Pathological diagnosis in ureteropelvic junction obstruction (UPJO) is crucial in deciding sufficient interventions. However, intrinsic and extrinsic UPJO can only be distinguished by carefully inspecting intraoperatively. The presented study aims to evaluate the role of the intraoperative diuretic test (IDT) in managing UPJO in adults. We evaluated the outcomes of 32 patients who underwent retroperitoneal laparoscopy surgery for UPJO from October 2021 to June 2022. IDT was administered for all patients after removing external causes, if any. Post-test morphological changes in the ureteropelvic were observed and used as evidence for pyeloplasty. Patients were followed up for at least 4&#xa0;months to assess the success and recurrence rate. Intrinsic and extrinsic were initially diagnosed in 12 (37.5%) and 20 (62.5%) cases. For 12 intrinsic UPJO, pyeloplasty was performed at the suspected stenosis segment, which was revealed apparently by IDT. For others, extrinsic causative pathologies were removed. Six of 20 patients did not respond with IDT and, thus, were not indicated for pyeloplasty. The rate of comorbidly intrinsic cases was 70% (14/20), proved by histological results of fibrous stenosis. Only one patient in a group who underwent pyeloplasty had signs of recurrent obstruction after 4&#xa0;months of follow-ups. IDT is the potential and minimally invasive method for controlling UPJO cases with comorbid pathologies and reducing the recurrent rate in the clinical setting.</p>

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Role of Intraoperative Diuretic Test on Managing Ureteropelvic Junction Obstruction by Laparoscopy

  • 期刊论文

  • 发表日期：

    2025年4月24日

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  • Hoang Huy Nguyen,
  • Thanh Truong Do,
  • Minh Duc Nguyen,
  • Son Ngoc Do,
  • Bac Hoai Nguyen

摘要

Pathological diagnosis in ureteropelvic junction obstruction (UPJO) is crucial in deciding sufficient interventions. However, intrinsic and extrinsic UPJO can only be distinguished by carefully inspecting intraoperatively. The presented study aims to evaluate the role of the intraoperative diuretic test (IDT) in managing UPJO in adults. We evaluated the outcomes of 32 patients who underwent retroperitoneal laparoscopy surgery for UPJO from October 2021 to June 2022. IDT was administered for all patients after removing external causes, if any. Post-test morphological changes in the ureteropelvic were observed and used as evidence for pyeloplasty. Patients were followed up for at least 4 months to assess the success and recurrence rate. Intrinsic and extrinsic were initially diagnosed in 12 (37.5%) and 20 (62.5%) cases. For 12 intrinsic UPJO, pyeloplasty was performed at the suspected stenosis segment, which was revealed apparently by IDT. For others, extrinsic causative pathologies were removed. Six of 20 patients did not respond with IDT and, thus, were not indicated for pyeloplasty. The rate of comorbidly intrinsic cases was 70% (14/20), proved by histological results of fibrous stenosis. Only one patient in a group who underwent pyeloplasty had signs of recurrent obstruction after 4 months of follow-ups. IDT is the potential and minimally invasive method for controlling UPJO cases with comorbid pathologies and reducing the recurrent rate in the clinical setting.