Fallon Elizabeth, Ercole Barbara, Lee Courtney, Best Sara, Skenazy Jason, Monga Manoj
Department of Urologic Surgery, University of Minnesota, Minneapolis, Minnesota 55455, USA.
J Endourol. 2005 Jan-Feb;19(1):41-4. doi: 10.1089/end.2005.19.41.
Ureteropelvic junction (UPJ) obstruction can be addressed surgically by an open, laparoscopic, endoscopic, or fluoroscopic procedure. Our objective was to establish what surgical alternatives are currently offered by urologists in Minnesota.
A questionnaire was sent to 174 members of the Minnesota Urological Society. Practice settings were characterized as rural, urban, or metropolitan on the basis of the ZIP-code classifications of the Minnesota Ambulance Association and state geographic legislation. Respondents were asked to select initial treatment options for an adult patient with flank pain, decreased renal function, and hydronephrosis secondary to UPJ obstruction.
Whereas 60% of the respondents would offer open pyeloplasty, only 12% would offer it as the only treatment option. The two most common minimally invasive therapies offered were the Acucise balloon (48%) and percutaneous antegrade endopyelotomy (48%). Rural urologists were more likely to offer Acucise balloon incision (71%) than were urban (28%; P=0.045) or metropolitan (55%; P=0.412) urologists.
The majority of urologists still offer open pyeloplasty as first-line therapy for UPJ obstruction. Further emphasis should be placed on increasing the availability of endoscopic and laparoscopic procedures.
肾盂输尿管连接处（UPJ）梗阻可通过开放手术、腹腔镜手术、内镜手术或透视介入手术来治疗。我们的目的是确定明尼苏达州的泌尿科医生目前提供哪些手术替代方案。
向明尼苏达泌尿外科学会的174名成员发送了一份调查问卷。根据明尼苏达救护车协会的邮政编码分类和州地理立法，将执业地点分为农村、城市或大都市。要求受访者为一名因UPJ梗阻继发胁腹疼痛、肾功能减退和肾积水的成年患者选择初始治疗方案。
60%的受访者会提供开放性肾盂成形术，但只有12%的受访者会将其作为唯一的治疗选择。提供的两种最常见的微创治疗方法是Acucise球囊扩张术（48%）和经皮顺行腔内肾盂切开术（48%）。农村泌尿科医生比城市（28%；P = 0.045）或大都市（55%；P = 0.412）的泌尿科医生更有可能提供Acucise球囊切开术（71%）。
大多数泌尿科医生仍将开放性肾盂成形术作为UPJ梗阻的一线治疗方法。应进一步强调增加内镜和腹腔镜手术的可及性。
