Outcomes of Laparoscopic Pyeloplasty at a Tertiary Care Centre in Kathmandu

Abstract

Ureteropelvic junction obstruction (UPJO) causes hydronephrosis and is often diagnosed in childhood, though many cases present in adulthood as undetected congenital disease. While open pyeloplasty has been the traditional gold standard with high success rates, laparoscopic pyeloplasty offers comparable outcomes. Since 2022, our institution has adopted this approach, and this study retrospectively evaluates our initial experience. This was a single-center, retrospective study of patients who underwent laparoscopic pyeloplasty at the Department of Urology, KIST Medical College and Teaching Hospital, Lalitpur, Nepal. The study was conducted on cases performed from January 2022 to March 2025. Median age was 23 years with male predominance (60%). Right-sided UPJO was more common (54%). Flank pain predominated (74%) the presenting symptoms. Mean operative time was 152 minutes. Open conversion occurred in three cases. Symptom relief occurred in 88.6%, with improved split renal function and eGFR. Laparoscopic pyeloplasty is feasible at KIST Medical College and Teaching Hospital, with satisfactory short-term outcomes despite an initial learning curve. Larger prospective studies with longer follow-up are needed to validate long-term efficacy.