Title: Foley Y-V Plasty in the Management of the Lower Pole Pelvi-ureteric Junction Obstruction in Incomplete Duplicated System
Authors: Shanky Singh, Priyabarta Das, Vaibhav Vikas, Jatin Soni
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.215
Abstract
Background: Pelvi-ureteric junction obstruction (PUJO) is a relatively common finding during urological investigation.1 Duplex kidney is the most common congenital abnormality of the urinary tract, with an incidence of around 2%.2 The combination of duplex kidney and PUJO is a rare association and mostly affects the lower pole. Surgical treatment can be challenging in such cases. We report our experience with the foley y-v pyeloplasty for the treatment of the lower pole PUJO in incomplete duplex systems.
Materials and Methods: In between July 2014 and April 2017, seven patients were identified with the lower pole PUJO associated with incomplete duplicate system. There demographic, diagnostic, and procedural data were recorded. Investigations included renal ultrasonography, renal scintigraphy, micturating cystography, cystoscopy and retrograde pyelography. All had foley y-v pyeloplasty surgery. Treatment outcome was assessed in terms of quality of life, recurrence and complications.
Results: At a mean follow-up of 23 months all were symptomatic free. Their median age was 11.28 yrs (range 5-23 yrs). Incidental hydronephrosis was detected in 3 patients, and 4 had a recurrent febrile urinary tract infection. Foley y-v plasty was performed in all patients No complications were detected during follow-up and all had a good quality of life.
Conclusion: Foley y-v plasty is a good surgical option in the management of the lower pole PUJO associated with incomplete ureteral duplication but it should be individualized for every patient.
Keywords: Pelvi-ureteric Junction Obstruction (PUJO); Incomplete Duplicated System; Lower Pole; Foley Y-V plasty.
