Ureteropelvic junction obstruction (UPJO) is a condition where the flow of urine from the renal pelvis to the proximal ureter is hindered. The incidence of congenital (primary) UPJO is approximately 1 in 500 with a male-to-female ratio of 2:1. If left untreated, UPJO may lead to loss of renal function.1 The surgical correction of UPJO is essential to prevent further damage to nephrons. Open pyeloplasty (OP) was the traditional gold standard for the treatment of UPJO, with success reported in more than 90% of cases. Laparoscopic pyeloplasty (LP) has been shown to duplicate the high success rates achieved with OP. LP is now considered the new gold standard with functional outcomes comparable to OP. This retrospective study aimed to compare the efficacy and safety of laparoscopic pyeloplasty versus open pyeloplasty in adult patients presented with ureteropelvic junction obstruction.

Data from 46 adult patients who underwent surgery for PUJO at the Department of Urology Surgery, Sultan Qaboos University Hospital, between January 2014 and December 2023 were reviewed. Patients were categorized into two groups based on surgical approach: LP and OP. All statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 27 (IBM, Armonk, NY, USA).

Forty-six pyeloplasty procedures were performed LP in 36 (78%) and OP in 10 (22%) cases. The mean hospital stay was shorter (p < 0.05) in the laparoscopic group as compared to open cases. There was also a significant difference in pain score (<0.05), with less analgesia required in the laparoscopic versus open group. There was no significant difference in estimated blood loss and surgery time. Overall, in 36 (78%) cases, the crossing vessels were identified, and postoperative complications were in 7 (15.2%) cases. The mean follow-up was 14.0±10.8 months. The overall success rates were 91.3%, with growing experience we observed an increase in trend towards the laparoscopic approach.

Laparoscopic pyeloplasty is a safe procedure with shorter hospital stay and less pain. In our unit we observed that there is a inclination toward a minimally invasive approach which is in line with the global trend.