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IntroductionAnderson-Hynes (A-H) dismembered pyeloplasty has remained nearly unchanged since its introduction in 1949. The authors present a modification of the uretero-pelvic anastomosis as described by Anderson and Hynes. The new approach, called the W-type suture, is thought to be more watertight and associated with fewer complications than the original.AimTo assess the effectiveness of the modification of Anderson-Hynes dismembered pyeloplasty named the W-type suture.Material and methodsThe research is a retrospective study of 99 patients who underwent laparoscopic A-H pyeloplasty. In 49 patients unmodified laparoscopic A-H pyeloplasty was carried out. Fifty patients underwent laparoscopic A-H pyeloplasty with the anastomosis made using the aforementioned W-type suture. To assess the effectiveness of the W-type suture, we compared urine leakage duration – a direct indicator of anastomosis tightness – and frequency of postoperative complications.ResultsThe mean duration of urinary leakage was 3 ±1.16 days for the W-type suture anastomosis group and 3.57 ±1.14 days for the unmodified A-H pyeloplasty group (p < 0.05). The frequency of post-operative complications did not statistically significantly differ between the groups except for fever (18.4% vs. 4%; p < 0.05).ConclusionsThe analysis of the collected data showed that the W-type suture might be a promising alternative to a traditional approach of performing the ureteropelvic anastomosis. Further research should be done to minimize biases present in this study, which might have influenced our results.

Background: A change in the assessment of treatment effectiveness is currently observed. More and more emphasis is being placed on assessing the impact of treatment on patients’ quality of life (QoL). Data on postoperative quality of life in patients undergoing pyeloplasty is scarce. The aim of the study was to assess the quality of life of patients who had undergone laparoscopic pyeloplasty due to ureteropelvic junction obstruction.Methods: The study group consisted of 95 patients who had consecutively undergone laparoscopic pyeloplasty due to ureteropelvic junction obstruction in a single center, between 2002 and 2009, from whom 26 consented to participate in a study. We evaluated their quality of life using WHOQOL-BREF questionnaire and an additional form, created by one of the authors, prepared to assess specifically health related quality of life after pyeloplasty. In all the patients, postoperative, functional outcome was assessed using diuretic renography. Results: Mean follow-up time was 89.8 months. Overall, 96% of study patients were satisfied with the procedure and all of them would consent to another pyeloplasty if needed. Dissatisfaction of one patient was caused by an insufficient decrease in pain level. All the patients reported that the postoperative pain intensity did not significantly affect their life and professional activity. Conclusions: Laparoscopic pyeloplasty is associated with excellent functional outcomes and - most of all - the majority of patients are satisfied with the treatment results. There seems to be no correlation between functional outcome and postoperative satisfaction.