Open Versus Laparoscopic Dismembered Pyeloplasty Among Adult Patients With Primary Pelvi-Ureteric Junction Obstruction

Inclusion Criteria: All adult patients (above 18 years old) with primary pelvi-ureteric junction obstruction indicated for active intervention as * Symptoms such as recurrent flank pain, recurrent urinary tract infection and rarely hypertension. * Breakthrough urinary tract infections while on prophylactic antibiotics. * Increasing renal antero-posterior diameter, or decreasing renal parenchymal thickness by ultrasound. * Low or decreasing differential renal function, but above 10%. Exclusion Criteria: * Patients having poor ipsilateral renal function \< 10%. * Patients with previous pelvi-ureteric junction obstruction repair. * Associated renal stones. * Patients unfit for surgery according to American Society of Anesthesiologists classification. * Contraindications for laparoscopy as (marked obesity, large ventral hernias, gross coagulopathy, abdominal wall sepsis, vertebral deformities…). * Pediatric patients. * Pregnant women. * Vesicoureteral reflux. * Congenital renal anomalies as (horse- shoe kidney, pelvic kidney, mal- rotated kidney ...). * Single functioning kidney. * Malignancy. * Refusal of written consent.