Endourologic management of ureteropelvic junction (UPJ) obstruction was introduced by Whitfield and Wickham in 1983 as a “percutaneous pyelolysis”<sup>20Ramsay J.W.A., Miller R.A., Kellett M.J., e al. Percutaneous pyelolysis: Indications, complications and results Br J Urol 1984 ;  56 : 586 [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> and popularized shortly thereafter in the United States by Smith<sup>1Badlani G., Eshghi M., Smith A.D. Percutaneous surgery for ureteropelvic junction obstruction (endopyelotomy): Technique and early results J Urol 1986 ;  135 : 26

Cliccare qui per andare alla sezione Riferimenti</sup> who coined the term “endopyelotomy.” Despite various nuances in the name of the procedure and in the technique performed,<sup>14Korth K., Kuenkel M., Erschig M. Percutaneous pyeloplasty Urology 1988 ;  31 : 503

Cliccare qui per andare alla sezione Riferimenti, 19Ono Y., Ohshima S., Kinukawa T., e al. Endopyeloureterotomy via a transpelvic extraureteral approach J Urol 1992 ;  147 : 352

Cliccare qui per andare alla sezione Riferimenti, 24Van Cangh P.J., Jorion J.L., Wese F.X., e al. Endoureteropyelotomy: Percutaneous treatment of ureteropelvic junction obstruction: J Urol 1989 ;  141 : 1317

Cliccare qui per andare alla sezione Riferimenti</sup> the basic concept is constant and involves a full-thickness incision through the obstructing proximal ureter from the ureteral lumen out to the peripelvic and periureteral fat. The incision is stented and left to heal based on the early work of Davis, who used an “intubated ureterotomy” in the course of an open operative procedure for UPJ obstruction.<sup>8Davis D.M. Intubated ureterostomy: A new operation for ureteral and ureteropelvic strictures Surg Gynecol Obstet 1943 ;  76 : 513

Cliccare qui per andare alla sezione Riferimenti</sup>

Initially, the percutaneous approach for definitive management of UPJ obstruction was limited to patients undergoing percutaneous removal of associated stones or to patients who had previously failed open pyeloplasty. The good results obtained ultimately led many centers to offer endopyelotomy as primary therapy for almost any patient with UPJ obstruction. This article reviews the indications, techniques, results, and complications associated with percutaneous management of UPJ obstruction.