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Endopyelotomy is a minimally invasive surgical procedure used to treat ureteropelvic junction (UPJ) obstruction, a condition where the connection between the kidney and the ureter is blocked, leading to impaired urine flow and potential kidney damage. The procedure involves using a small endoscope to access and repair the obstruction from within the ureter and renal pelvis. Typically performed through the urinary tract without the need for external incisions, endopyelotomy aims to relieve the obstruction, restore normal urine flow, and preserve kidney function. The primary cause for performing an endopyelotomy is to address symptoms and complications arising from UPJ obstruction, which can include persistent pain, recurrent urinary tract infections, and impaired kidney function. UPJ obstruction may be congenital or acquired due to factors such as kidney stones, scarring, or tumors. The procedure is often indicated when conservative treatments or other less invasive methods, such as balloon dilation or stenting, have failed to resolve the obstruction. Despite its minimally invasive nature, endopyelotomy carries potential complications. Risks include infection, bleeding, and injury to surrounding tissues or organs. Specific complications can involve incomplete resolution of the obstruction, which may necessitate additional procedures, or development of scar tissue that could lead to recurrent obstruction. Other potential issues include ureteral stricture or leakage from the surgical site. Postoperative care involves monitoring for signs of complications, managing pain, and ensuring proper kidney function and urine flow. Follow-up visits are essential to assess the success of the procedure and address any issues that arise during recovery.