Comparative evaluation of the resolution of hydronephrosis in children who underwent open and robotic-assisted laparoscopic pyeloplasty

J Pediatr Urol. 2013 Apr;9(2):199-205. doi: 10.1016/j.jpurol.2012.02.002. Epub 2012 Mar 3.


Objectives: To assess long-term postoperative ultrasonographic outcomes of robotic-assisted laparoscopic pyeloplasty (RALP) and of conventional open pyeloplasty (COP) in pediatric patients with ureteropelvic junction obstruction.

Methods: Retrospective review of 312 patients who underwent RALP or COP in a single institution. Preoperative and postoperative ultrasounds were used to determine the grade of hydronephrosis. Postoperative assessment included 3 ultrasounds at 0-6, 6-12 and >12 months intervals. Patients were matched by age, etiology of obstruction, grade of preoperative hydronephrosis and gender for case-matched analysis.

Results: We identified 212 pyeloplasties that met inclusion criteria, being 58 RALP and 154 COP. Groups were different in age, gender and etiology, but similar in severity of hydronephrosis and follow-up time. At the end of follow-up, complete resolution and success rates were 62% and 74% in RALP and 45% and 70% in COP, respectively. Matching included 105 patients. Complete resolution was higher in RALP (p = 0.004), while median time before improvement was lower (12.3 months RALP vs 29.9 months COP). There was no difference in success rate at the end of follow-up between the groups.

Conclusion: RALP shows satisfactory long-term outcomes, comparable to COP. In our cohort, patients who underwent robotic pyeloplasty showed faster resolution of hydronephrosis on ultrasound.

Publication types

  • Comparative Study

MeSH terms

  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Hydronephrosis / diagnostic imaging
  • Hydronephrosis / surgery*
  • Infant
  • Kaplan-Meier Estimate
  • Laparoscopy / methods*
  • Male
  • Postoperative Complications / diagnostic imaging
  • Retrospective Studies
  • Robotics*
  • Treatment Outcome
  • Ultrasonography
  • Ureteral Obstruction / surgery*
  • Urologic Surgical Procedures / methods*