Introduction: The aim of the present study wasto evaluate the long-term results of adult open pyeloplasties performed by the Anderson-Hynes technique in the era of new endourologic procedures. Materials and Methods: The medical records of 180 adult patients who underwent Anderson-Hynes pyeloplasty with a diagnosis of ureteropelvic junction (UPJ) obstruction, were retrospectively reviewed. Pre- and postoperative results were compared with clinical, radiologic and radionuclide studies. The mean age of the patients was 33.2 (16–65) years. The minimum clinical follow-up time was 12 months and the mean time from the operation was 9.4 years (between 1 and 17 years). Results: Success was defined as resolution of symptoms and decrease in pyelocaliceal volume and calicectasis. The overall success rate was 91.1%. The success rate was between 93.1 and 100% in patients with grades I–III and 62.5% in patients with grade IV hydronephrosis and contribute to renal function less than 25%. The pyelocaliceal volume returned to normal in 39 (21.7%) patients, significantly decreased in 82 (45.5%), and the flow of contrast media from renal pelvis to ureter improved in 43 (23.9%) and did not change or increased in 16 (8.9%). The failure happened in the first 3 months in 57% of patients and in long-term follow-up in 43% of patients. Conclusion: Despite newer endoscopic techniques, Anderson-Hynes pyeloplasty, with an over 90% success rate remains the gold standard in the treatment of primary UPJ obstruction.

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