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IP45-15 A MULTI-INSTITUTIONAL ANALYSIS OF REVISION SURGERY AMONG PATIENTS WITH PRIOR PYELOPLASTY
Abstract   Peer reviewed

IP45-15 A MULTI-INSTITUTIONAL ANALYSIS OF REVISION SURGERY AMONG PATIENTS WITH PRIOR PYELOPLASTY

Sweta Parija, Shawn Grove, Dhruv Puri, Nishant Garg, Kshitij Pandit, Anh Nguyen, Jeremy Myers, Salt Lake City, Benjamin McCormick, Sima Daryabari, …
The Journal of urology, Vol.215(5S), p.e919
05/2026
DOI: 10.1097/01.JU.0001191548.79667.9d.15

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Abstract

INTRODUCTION AND OBJECTIVES: Recurrent ureteral pelvic junction obstruction following pyeloplasty remains a challenging clinical problem with limited data to guide management. This study evaluated demographic and operative factors associated with recurrence and outcomes following revision of pyeloplasty across multiple institutions. METHODS: A multi-institutional retrospective review evaluated 45 patients from 7 centers who underwent revision surgery between 2013 and 2024 for recurrent ureteral pelvic junction obstruction following prior pyeloplasty. Demographic, operative, and outcome data were collected. Etiology was categorized as idiopathic, traumatic, infectious, fibrotic, or congenital. Recurrence was determined by the need for reintervention, such as the need for ureteral stent, nephrostomy tube, or further revision surgery. Unpaired t-tests compared pre- and postoperative GFR, creatinine, MAG3 renal scan, and SFU hydronephrosis grade using a p-value < 0.05 to indicate significance. RESULTS: Mean age was 46.6 ± 19.7 years, and mean follow-up was 13.8 months. Twelve-month recurrence free survival was 93.3% (Table 1). All recurrent obstructions are in the proximal ureter (S1). Postoperative SFU hydronephrosis grade was significantly lower than preoperative (95% CI, 1.50–2.85; p0.001; Figure 1). No significant differences were observed in GFR, creatinine, or MAG3 renal scan. Three patients required retreatment (6.7%). The overall complication rate was 26.7%, with urinary tract infections being the most common. CONCLUSIONS: Revision surgery for recurrent ureteral pelvic junction obstruction after prior pyeloplasty demonstrates high success. Kidney function is maintained with no change in GFR and showed improvement in hydronephrosis postoperatively. Revision surgery remains a safe and effective treatment for recurrent UPJ obstruction with success rates comparable to primary repair.

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