Objectives: a prospective review of our experience and midterm results of laparoscopic pyeloplasty (LP) for patients who have failed open or laparoscopic pyeloplasty in adult.
Material and methods: Thirty two patients with failed open pyeloplasty were reviewed; all of them had transperitoneal dismembered LP. All procedures were performed by experienced laparoscopist during the period from March 2015 to March 2017.
Results: The study group consisted of 14 men and 18 women with the mean age of 29± 6 years. Mean operative time was 186± 57 and 123± 22 minutes in the secondary and primary LP groups, respectively. Mean hospital stay was 4.7 ± 2.3 and 4.3 ± 2.1 days in the two groups, respectively. Mean follow-up was 5.6 ± 2.15 months (range 3-9months). The overall success rate for secondary LP was 90.6% compared to 94.4% in the primary LP group. There was no conversion to open surgery in both groups. Intraoperative and postoperative complications in secondary and primary LP were 9.4 and 12.5% versus 0 and 5.6% in both groups, respectively.
Conclusions: Redo LP is a safe and viable treatment option for secondary uretreopelvic junction obstruction with a success rate similar to that of primary repair but with longer operative time. A good experience in laparoscopic reconstructive procedures is a prerequisite for optimal results.