an intervention study on adult patients with uretero-pelvic junction obstruction (UPJO) due to crossing vessels would be managed either through classic dismembered pyeloplasty or vascular hitch.

in recent studies, some patients with crossing vessels UPJO could be managed by vascular displacement of these vessels, what is named as vascular hitch or vasculopexy in a way to avoid classic dismembered technique. this newer technique is supposed to provide comparable results to the classic technique but with lesser operative time and shorter hospital stay. in the era of minimally invasive procedures, robotic assisted or laparoscopic vascular hitch could provide many advantages over the classic open technique.

Inclusion Criteria:

• all patients with UPJO above 18 years
• UPJO caused by crossing vessels confirmed by CT angiography
• Symptomatic UPJO

Exclusion Criteria:

• recurrent UPJO after a previous trial of open repair ,
• secondary UPJO after open renal surgery.
• UPJO in non functioning kidney

the researchers would determine whether they would share or not during the study

one blind