Diagnosis of 65 cases of ampullary renal pelvis after postnatal follow-up of 1,167 newborn infants with prenatally suspected hydronephrosis

Abstract

The aim of the present study was to assess the morbidity of ampullary renal pelvis (ARP) and document its natural history in post-natal life. A total of 1,167 newborn infants with prenatally suspected hydronephrosis were retrospectively analyzed. Of these, 65 patients were diagnosed with ARP by computed tomography urography (CTU) and/or magnetic resonance urography (MRU). All cases were followed up with ultrasonogrophy at 1, 3, 6 and 12 months after birth, and one case was followed up for 5 years. Changes in the separation of the renal pelvis collection system were recorded. Children with ARP accounted for 5.57% of the total cases (65/1,167) followed-up. No lack of connection between the renal calyces and the renal pelvis was detected. The long-term follow-up revealed that the separation of the renal pelvis collection system did not tend to increase over time. In addition to imaging examinations, long-term follow-up observation is recommended for the accurate diagnosis of pediatric ARP, particularly for differentiation from hydronephrosis.

Anatomical study of the renal excretory system in pigs. A review of its characteristics as compared to its human counterpart

“…Consistent with the findings of numerous authors [3,6,17,22,24,34,35] in our series we found the ampullar type of renal pelvis as having the lowest incidence (5.6-10%). Of note, Szymański et al [34] reported this pattern with a significant frequency of 30%, while presenting disagreement about the most frequent type.…”

“…Others [3,6,24] indicate the bifurcated presentation as the most common one, within a range of 45-60%. Since early hydronephrosis expresses itself morphologically with the presence of an ampullar pelvis in humans, it has been postulated that before labelling this feature as an anatomical variant in the clinical scenario, one must rule out an urinary tract obstruction generated by lithiasis, stenosis of the pyeloureteral junction, vesicoureteral reflux, or extrinsic compression caused by light adhesions of the lower polar renal arteries or the gonadal vessels [6,35]. Similarly, it has been postulated that since bifurcated renal pelvises handle smaller urinary volumes, they could become an anatomical substrate for the formation of stones inside these structures [1,18].…”

Outcome analysis of early surgery and conservative treatment in neonates and infants with severe hydronephrosis

“…10 Zhang et al showed that the degree of hydronephrosis was not aggravated in a long-term follow-up, and the thickness of the renal parenchyma was not significantly changed. 11 Therefore, these authors considered that fetal hydronephrosis should not be treated immediately after delivery, and it must be closely followed up until surgery instead.…”