Does Renal Function Remain Stable After Puberty in Children With Prenatal Hydronephrosis and Improved Renal Function After Pyeloplasty?

Chertin, Boris; Pollack, Avner; Koulikov, Dmitry; Rabinowitz, Ron; Shen, O.; Hain, Daniel; Hadas-Halpren, Irit; Farkas, Amicur

doi:10.1016/j.juro.2009.03.008

Cited by 44 publications

(23 citation statements)

References 11 publications

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“…In one series of children who underwent surgical repair, relative renal function improved from 37 percent preoperatively to 43 percent [15]. Five percent have recurrence of obstruction after surgery [16].…”

Section: Discussionmentioning

confidence: 99%

Profile and Outcome of Pelviureteric Junction Obstruction

Senguttuvan

Jigy²

2014

TOUNJ

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Abstract:Obstructive uropathy represents one of the largest fractions of identifiable causes of renal failure in pediatric populations. This is one of the largest series of PUJ obstructions reported in children. PUJ obstruction is a relatively common congenital anamolyes in neonates and children and a cause of ESRD in developing countries. This series expands our knowledge about the clinical presentation and course of this disease. Pelviureteric junction (PUJ) obstruction is a partial or total blockage of the flow of urine that occurs where the ureter enters the kidney and is the most common cause of significant dilatation of the collecting system in the fetal kidney. We retrospectively analyzed children diagnosed as PUJ obstruction between the periods of 2008-2010 who presented to our institute. Forty four children were diagnosed to have PUJ obstruction. The median age at presentation was 11 months, with range of 3 months to 11 years. Male children constituted 34 (77.3%) cases. Unilateral PUJ with left sided involvement was more common (52.3%). Antenatal diagnosis was made in 18 (40.9%) cases. The common clinical presentations were fever, urinary tract infection (UTI) and abdominal pain. Hypertension was present in five (11.3%) patients and renal failure at presentation was seen in eight (18.2%) patients. Associated urogenital anomalies were present in twelve (27.3%) patients, with medullary cystic kidney disease (MCKD) being the most commonassociated anomaly. Prophylactic antibiotics were not prescribed to patients. Urinary tract infection was present in fourteen (31.9%) patients with E. coli being the most common organism (75%). Conservative management with regular follow up was done for 32 patients and the remaining twelve patients underwent pyeloplastyin view of gross hydronephrosis, and four (33.3%)of these patients later underwent nephrectomy for a nonfunctioning kidney. Antenatal screening is mandatory to make an early diagnosis and for further management and close follow upof PUJ obstruction. Randomized control trials and longer follow up studies are needed for evidence to suggest the optimal management.

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Section: Discussionmentioning

confidence: 99%

Profile and Outcome of Pelviureteric Junction Obstruction

Senguttuvan

Jigy²

2014

TOUNJ

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“…7,8 Çalışmamızda ise yine erkek cinsiyet fazla olmasına rağmen bu oran 1,27'dir. Sol/sağ oranı 1,96 olarak bulunmuş-tur.…”

Section: Discussionunclassified

“…The average duration of surgery is 168 (±51. 7) minutes. Hasson open technic was used in 23 (27.3%) patients and the other hand Veress needle technic was used in 61 (72.7%) of all.…”

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confidence: 99%

Laparoscopic Pyeloplasty Experience of Adana Numune Training and Research Hospital

Kuyucu¹,

Deniz²,

Tümer³

et al. 2018

J Reconstr Urol

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Ö ÖZ ZE ET T A Am ma aç ç: : Laparoskopik piyeloplasti, özellikle son yıllarda sıklıkla kullanılmaya başlanmış, minimal invaziv cerrahi olmasının da etkisiyle pek çok ürolojik merkezde birinci basamak tedavi olarak kabul edilmiştir. Bu çalışmada, kliniğimizde uygulanan laparoskopik piyeloplasti deneyimlerimizin sunulması amaçlanmıştır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Kliniğimizde Ağustos 2011-Şubat 2017 tarihleri arasında, laparoskopik piyeloplasti operasyonu yapılan hastaların dosyaları retrospektif olarak değerlendirildi. Port giriş tekniği olarak Hasson ve Veress iğne girişi yapıldı. Uygun hastalarda transmezokolik onarım yapılır iken, diğerlerinde kolon mediyalize edildi. Üreteropelvik darlık onarımında Anderson Hynes (dismembered) tekniği kullanıldı. B Bu ul lg gu ul la ar r: : Çalışmaya alınan 84 hastanın yaş ortalaması 21,3 (±13,6) yıldır. Ameliyat süresi ortalama 168 (±51,7) dk'dır. Hastaların 23 (%27,3)'üne Hasson, 61 (%72,7)'ine Veress girişi yapıldı. Hastaların 16 (%19)'sına transmezokolik onarım yapılmış iken, 68 hastada kolon kraniyalize edildi (%81). DJ kateter 79 (%94,1) hastaya takıldı. Postoperatif hastanede kalış süresi 3,59 (±1) gün idi. . S So on nu uç ç: : Üreteropelvik bileşke darlığında etkin cerrahi yöntem piyeloplasti olup, laparoskopik yöntemler cerrahi etkinlik, minimal hastanede kalış süresi, daha az intraoperatif hemoraji, postoperatif ağrının az olması açısından oldukça geçerli bir metoddur.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Laparoskopi; piyeloplasti; üreteropelvik bileşke; üriner darlıklar A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Laparoscopic pyeloplasty has been accepted as a first-line treatment in many urological centers, especially due to the fact that it has been used frequently in recent years and it is minimally invasive surgery. In this study, we aimed to present our experience of laparoscopic pyeloplasty in our clinic. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Patients who underwent laparoscopic pyeloplasty between August 2011-February 2017 were evaluated retrospectively. Hasson and Veress needle entry was made as port input technique. At appropriate times, transmesocolic repair was performed and the colon was medialized at other occasions. Anderson Hynes (dismembered) technique was used to repair ureteropelvic obstructions. R Re es su ul lt ts s: : The average age of 84 patients taken into employment is 21.3 (±13.6). The average duration of surgery is 168 (±51.7) minutes. Hasson open technic was used in 23 (27.3%) patients and the other hand Veress needle technic was used in 61 (72.7%) of all. Transmesocolic repair was performed in 16 (19%) patients and colon cranialization was performed in 68 (81%) patients. The DJ catheter was attached to 79 (94.1%) patients. The duration of stay in the postoperative hospital was 3.59 (±1) days. C Co on nc cl lu us si io on n: : Effective surgical method for ureteropelvic junction obstruction is pyeloplasty and laparoscopic methods are a very effective method ...

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“…Considering that pyeloplasty is a successful procedure, a large number of diuretic renograms would be obtained to detect a small subpopulation. Moreover, previous reports have suggested that multiple nuclear scans are unnecessary, as significant fluctuations in split function over time are uncommon [13,14]. So a more simple and objective approach is justified.…”

Section: Discussionmentioning

confidence: 99%

Can Renal Ultrasonography Predict Early Success after Pyeloplasty in Children? A Prospective Study

Helmy¹,

Harraz²,

Sharaf

et al. 2014

Urol Int

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Objective: To study the predictive value of 6 ultrasonographic (USG) parameters for early detection of children at risk of recurrent obstruction. Patients and Methods: A prospective nonrandomized study included all patients who underwent pyeloplasty between 2010 and 2012. All of the patients had completed at least 6 months of follow-up and preoperative and postoperative USG imaging data were available. The primary outcome was the correlation between USG and diuretic scintigraphic parameters. The secondary outcome was the predictive ability of the pelvicalyceal system parameters, measured by USG, of parenchymal growth after surgery. Results: Sixty-eight patients were evaluated. The mean age was 3.6 years (range 0.1-12). The mean (± standard deviation) differential renal function improved from 37.4 ± 11 ml/min to 37.7 ± 14 ml/min, which was a difference of no statistical significance.On the other hand, the mean (± SD) half-time (T_1/2) significantly improved. After constructing a linear regression model of the 4 USG parameters and the parenchymal growth, the model explained 57.2% of the variance in parenchymal growth after pyeloplasty. The calyx-to-parenchyma ratio change was the largest unique contribution for explaining the variance in parenchymal growth, followed by anteroposterior diameter and calyceal dilatation. Conclusion: We proved that calyx-to-parenchyma ratio, anteroposterior diameter and calyceal dilatation are independent predictors of early success after pyeloplasty.

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Does Renal Function Remain Stable After Puberty in Children With Prenatal Hydronephrosis and Improved Renal Function After Pyeloplasty?

Abstract: To our knowledge our data show for the first time that successful pyeloplasty after the prenatal diagnosis of ureteropelvic junction obstruction is associated with improved renal function throughout puberty.

Cited by 44 publications

References 11 publications

Profile and Outcome of Pelviureteric Junction Obstruction

Profile and Outcome of Pelviureteric Junction Obstruction

Laparoscopic Pyeloplasty Experience of Adana Numune Training and Research Hospital

Can Renal Ultrasonography Predict Early Success after Pyeloplasty in Children? A Prospective Study

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