[Surgical cure of anomalies of the pyelo-ureteral junction with posterior vertical lumbar excision: report of 25 cases].

Posterior vertical lumbar (PVL) incision does not involve any muscle or nerve section. It is minimally painful, does not give rise to incisional hernias and reduces the hospital stay. Pyeloplasty for cure of the ureteropelvic junction (UPJ) is a good indication, as this incision provides access to the renal pelvis without renal mobilisation and without interference by the vascular pedicle and allows a more superficial operative field. This retrospective study is based on 25 PVL incisions performed between 1979 and 1992 in 24 patients (15 females and 6 males with a mean age of 31.8 years) on the left kidney in 11 cases, right kidney in 12 cases and bilaterally in 1 case. No intraoperative complications were observed. The anastomosis was stented with a Gil-Vernet ureteronephrostomy tube for an average of eight days in every case. Early complications (< or = 1 month) consisted of six cases of fever, one wound abscess and one urinary fistula. Normal feeding was always rapidly restored. Long-term follow-up did not reveal any incisional hernias, but two cases of recurrence (8%), two cases of stones and one case (4%) of refractory neuralgia (> or = 6 months) in the territory of the ilioinguinal nerve. In this indication, there is no gain in terms of hospital stay due to the need to maintain the ureteronephrostomy tube for at least five days.(ABSTRACT TRUNCATED AT 250 WORDS)