Treatment of ureteropelvic stenosis and hydronephrosis. A literature review

Abstract

Introduction: Ureteropelvic stenosis is a narrowing at the level of the junction of the renal pelvis with the ureter which prevents the passage of urine and its expulsion, thus causing secondary hydronephrosis. There are several etiologies such as intrinsic or congenital and acquired, where congenital ones are most often observed. It causes clinical manifestations such as pain, hematuria, urinary tract infections to repeat and secondary to this, hematuria. The diagnosis can be prenatal with the help of ultrasound, in addition to more specific tests such as cystourethrography, diuretic renography, among others described later. Objectives: General: To prepare an updated bibliographic review article on the treatment of ureteropelvic stenosis and hydronephrosis. Specifics: Determine the most common etiologies of ureteropelvic stenosis and hydronephrosis. To know the clinical picture and complementary examinations associated with ureteropelvic stenosis and hydronephrosis. Provide a tool for early diagnosis of ureteropelvic stenosis. Describe proper management of ureteropelvic stenosis as required by the patient. Methodology: Using databases such as PUBMED, UpToDate, PMC, ELSEVIER, The Cochrane Library Plus, NCBI conducted an exhaustive search of scientific articles for the development of a descriptive study through a systematic updated bibliographic review. Results: The main findings show that there is greater efficacy of minimally invasive pieloplasty with a 7% failure rate, open pieloplasty 9% and endopielotomy 15%. Conclusions: Ureteropelvic stenosis is usually caused by congenital etiology. Nursing patients with this pathology are usually asymptomatic, since over time this problem has its solution, however, if there is no resolution after 18 months, there will be manifestations such as abdominal pain, there may be the presence of abdominal masses, hematuria. Surgical intervention is the gold standard for the treatment of this pathology.