Trends in ureteropelvic junction obstruction management among urologists in the United States

Tan, Beng Jit; Rastinehad, Ardeshir R.; Marcovich, Robert; Smith, Arthur D.; Lee, Benjamin R.

doi:10.1016/j.urology.2004.09.051

Cited by 55 publications

(38 citation statements)

References 19 publications

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“…This limitation precludes its widespread use. In a contemporary survey study looking at current practice patterns of primary UPJO, 78% of urologists in community practice stated they prefer an open approach while 67% of academic urologists stated that they prefer a laparoscopic approach (27). RAP has a potentially shorter learning curve (28) and may enable laparoscopic-naive urologist to perform the procedure easily, bridging the gap between academic and community urologists.…”

Section: Discussionmentioning

confidence: 99%

Robot-assisted pyeloplasty: outcomes for primary and secondary repairs, a single institution experience

Thom¹,

Haseebuddin²,

Roytman³

et al. 2012

Int. braz j urol.

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Section: Discussionmentioning

confidence: 99%

Robot-assisted pyeloplasty: outcomes for primary and secondary repairs, a single institution experience

Thom¹,

Haseebuddin²,

Roytman³

et al. 2012

Int. braz j urol.

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“…Open Pyeloplasty has considerable morbidity of the muscle cutting lumbar incision made [15]; [16] . Over past few years laparoscopic approach gave similar or even better results [5];[8]; [17] .…”

Section: Discussionmentioning

confidence: 99%

“…Each approach has its own advantages and disadvantages. Although transperitoneal approach has advantages like large working space, better field of vision, disadvantages like abdominal visceral injury, high incidence of post operative ileus, time consuming dissection to reach renal pelvis made most urologist still prefer open approach in recent trends [15]; [19] . Retroperitoneoscopic approach has the disadvantages of less working space, limited field of vision and altered anatomical orientation of structures.…”

Section: Discussionmentioning

confidence: 99%

A Comparative study between Retroperitoneoscopic and open Dismembered Pyeloplasty in the Management of Ureteropelvic Junction Obstruction

Venugopal¹

2017

JMSCR

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“…5,6 Formal laparoscopic training is less prevalent in the urologic community, which manifests as a lower utilization of minimally invasive pyeloplasties in this setting, compared with that in the academic setting. [6][7][8] Although the advent of robotic surgery has mitigated some of these challenges by reducing the learning curve, 5,9 its upfront expense (ie, capital investment of $1 million-$2.25 million 10 ) impedes its widespread adoption. Previous studies demonstrate that minimally invasive techniques for upper urinary tract procedures are influenced not only by patient characteristics, but also by surgeon-and hospital-level factors.…”

mentioning

confidence: 99%

Trends in the Treatment of Adults with Ureteropelvic Junction Obstruction

Jacobs

Kaufman

Morgenstern³

et al. 2013

Journal of Endourology

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Background and Purpose: Minimally invasive pyeloplasty is an effective treatment for patients with ureteropelvic junction obstruction that offers quicker convalescence than open pyeloplasty. Technical challenges, however, may have limited its dissemination. We examined population trends and determinants of surgical options for ureteropelvic junction obstruction. Patients and Methods: Using the State Inpatient and Ambulatory Surgery Databases for Florida, we identified adults who underwent ureteropelvic junction obstruction repair between 2001 and 2009. After determining the surgical approach (minimally invasive pyeloplasty, open pyeloplasty, or endopyelotomy), we estimated annual utilization rates and the effects of patient, surgeon, and hospital predictors on surgery type, using multilevel multinomial logistic regression. Results: Rates of minimally invasive pyeloplasty increased 360% (P for monotonic trend < 0.01), while rates of open pyeloplasty decreased 56% (P < 0.01). Rates of endopyelotomy were substantially higher and remained relatively stable (P = 0.27). Compared with open pyeloplasty, minimally invasive pyeloplasty was used more commonly among patients with private insurance (odds ratio [OR] 1.6; 95% confidence interval [CI], 1.2-2.3), those treated at teaching hospitals (OR 1.6; CI 1.0-2.6), and those treated by high-volume surgeons (OR 2.9; CI 2.0-4.2). Its use was less frequent among patients with multiple comorbidities (OR 0.53; CI 0.37-0.76). Similar associations were observed when comparing receipt of minimally invasive pyeloplasty with endopyelotomy; however, patients who underwent endopyelotomy were older. Conclusions: The use of minimally invasive pyeloplasty has dramatically increased, largely replacing open pyeloplasty, while the use of endopyelotomy, albeit significantly more common than the other approaches, has remained stable. The surgical approach is influenced by several patient, surgeon, and hospital factors.

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Trends in ureteropelvic junction obstruction management among urologists in the United States

Cited by 55 publications

References 19 publications

Robot-assisted pyeloplasty: outcomes for primary and secondary repairs, a single institution experience

Robot-assisted pyeloplasty: outcomes for primary and secondary repairs, a single institution experience

A Comparative study between Retroperitoneoscopic and open Dismembered Pyeloplasty in the Management of Ureteropelvic Junction Obstruction

Trends in the Treatment of Adults with Ureteropelvic Junction Obstruction

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