Modern Approach to Diagnosis and Treatment of Patients with Late Stages of Hydronephrosis Caused by Stricture of the Ureteropelvic Junction

Stricture of the ureteropelvic junction (UPJ) is one of the most common pathologies in urology, which can cause hydronephrosis. For a long time the disease can be asymptomatic, thus patients visit a physician at the late stages of the disease, when severe structural and functional changes in the kidney are developed. Early diagnosis makes it possible to stop or slow down the progression of loss of kidney functions and facilitate the effectiveness of treatment. The objective: analyze the effectiveness of diagnosis and treatment of the late stages of hydronephrosis, caused by UPJ stricture. Materials and methods. Since 2013 to 2021 37 patients with late stages of hydronephrosis (23 men and 14 women) in DU “Institute of Urology named after Academic O. F. Vozianov” of NAMS of Ukraine have been examined and treated. The age of the patients ranged from 10 to 71 years. The cause of hydronephrosis in all patients was UPJ stricture. Results. 30 patients (81%) underwent laparoscopic plasty of the UPJ with the Anderson-Hines method. The postoperative period was uneventful. In the long-term postoperative period, no recurrence of the UPS stricture was diagnosed. The effectiveness of the treatment method was 96.7%. In all patients, the secretory function of the operated kidney significantly improved. However, in 7 (19%) patients out of 37 it was not possible to preserve a kidney. Conclusions. The use of laparoscopic Laparoscopic plasty of the UPJ with the Anderson-Hines method in the treatment of late stages of hydronephrosis makes it possible to achieve good clinical results both in the short-term and in the long-term postoperative period. Further development of scientific data in terms of studying pathogenetically based methods of early diagnosis, searching for new criteria for assessing the functional reserve of a blocked kidney, identifying biomarkers that will allow predicting the risk of recurrence of UPJ stricture and monitoring the effectiveness of treatment, which is a relevant and promising area.