Summary
Purpose
To assess the outcome of successful pyeloplasty in infants with Ureteropelvic Junction
Obstruction (UPJO) and a differential renal function of (DRF) < 35% whether they can
attain normal postoperative renal function or not.
Methods
All children who were diagnosed with antenatal hydronephrosis due to UPJO were presented
to our institutions and were prospectively followed up. Pyeloplasty was performed
based on predefined indications such as: initial DRF ≤40%, progression of hydronephrosis,
and febrile urinary tract infection (UTI). A total of 173 children, who had successful
surgical intervention due to impaired DFR, were divided according to their pre-intervention
DRF value as follows: DRF <35% (group I) and DRF 35–40% (group II). The renal morphology
and function changes were recorded and used for comparison between both groups.
Results
Group I was comprised of 79 patients, and group II included 94 patients. Pyeloplasty
achieved significant improvement in the anatomical and functional indices in both
groups (p-value <0.001). The degree of improvement in Anteroposterior diameter (APD)
and cortical thickness was comparable in both groups (P-value, 0.64 and 0.44 respectively).
While the improvement in the DRF was significantly higher in group I (16.06 ± 6.6)
than in group II (6.25 ± 2.66) (P-value <0.001). Despite that, a significantly higher
percentage of infants in group II (61.7%) achieved normal final DRF compared with
only (10.1%) in group I (Figure).
Conclusion
Graphical Abstract
Keywords
Abbreviations:
ANH (antenatal hydronephrosis), APD (Anteroposterior diameter), DFR (differential renal function), DTPA (Diethylenetriamine pentaacetate), SFUG (Society for Fetal Urology Grade), UTI (urinary tract infection), UPJO (ureteropelvic junction obstruction), VUR (vesicoureteral reflux)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 19, 2023
Accepted:
February 13,
2023
Received in revised form:
February 3,
2023
Received:
September 30,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
