International Urology and Nephrology 32: 33–35, 2000. © 2000 Kluwer Academic Publishers. Printed in the Netherlands. 33 Is visualising ureter before pyeloplasty necessary in adult patients? M. Çakan, F. Yalçınkaya, F. Demirel &A. Satır Department of Urology, SSK Dı¸ skapı Training Hospital, Ankara, Turkey Abstract. In this study, we aimed to detect whether or not visualising ureter and ureteropelvic junction (UPJ) preoperatively is necessary in adult patients who have primer UPJ obstruction. Between January 1995 to June 1999, 46 renal units in 45 patients with primer UPJ obstruction were evaluated. The patients were separated into 2 groups. In group 1, intravenous pyelography (IVP) and renal scintigraphy were performed to 17 renal units preoperatively. In group 2, in addition to these methods, either retrograde pyelography (RGP) or antegrade pyelography (AGP) were performed to 29 renal units. Renal/bladder sonogram was used in patients with poor renal function in IVP or in renal scintigraphy. All the operations were performed through a flank incision. In group 2, additional information was gained for 8 (27.5%) of the renal units preoperatively. No additional information for this group found intraoperatively. In group 1, we found additional information in 4 (23.53%) of the units intraoperatively. All the pathologies in both groups were corrected intraoperatively. Double-J (D-J) stent was used in 6 (35.29%) of the units in group 1 and 8 (27.58%) of the units in group 2 intraoperatively (p> 0.05). In group 2, 4 (13.79%) preoperative complications were seen due to RGP and they were treated either medically or conservatively. In the early postoperative period, a complication observed in 1 (5.88%) of the patients in group 1 and 1 of the patients in group 2 (3.44%) (p> 0.05). The first patient was treated with inserting D-J and the latter one was treated conservatively. In the 3rd postoperative month, success rate was found to be 94.11% in group 1 and 96.55% in group 2 (p> 0.05). Additional pathologies in adult patients with primer UPJ obstruction can be corrected intraoperatively through a flank incision. Therefore, imaging of ureter and UPJ may not be necessary in these patients. Key words: Adult patients, Pyeloplasty, Ureter, Visualization Introduction Although UPJ obstruction is a congenital disease, it may be seen in age between prenatal period to advanced years. Renal/bladder sonogram, renal scin- tigraphy, and voiding cystography are usually used for the diagnose in children; in some cases, IVP and RGP may be necessary [1, 2]. In adult patients, in addition to IVP and renal scintigraphy, either RGP or AGP is performed frequently to differential diagnosis of some disease that located in UPJ (such as stone, tumor etc) and/or to planning type of operation [3–5]. In this study, we aimed to determine whether visual- ising ureter and UPJ are necessary in adult patients with primer UPJ obstruction preoperatively. Patients and methods In this study, 45 patients with primer UPJ obstruction were evaluated. Patients who had renal operation or whose IVP or renal/bladder sonogram showed filling defects in UPJ were not included in the study. Of the patients, 28 were male and 17 were female. The mean age of the patients were 28.32 (17–64). Fourty- six renal unites in the 45 patients were operated. Twenty-five pyeloplasty were performed to right kid- neys and 21 to the left kidneys. Because of bilateral UPJ obstruction, bilateral pyeloplasty was performed to only one of the patients. IVP and renal scinti- grafi that performed with 99 m technetium-labelled diethylenetriaminepentaacetic acid (Tc-DTPA) and