Hydronephrosis After Pyeloplasty: “Will It Go Away?”

Carpenter, Christina P.; Tolley, Elizabeth A.; Tourville, Elizabeth; Sharadin, Cynthia; Giel, Dana W.; Gleason, Joseph M.

doi:10.1016/j.urology.2018.08.010

Cited by 14 publications

(13 citation statements)

References 23 publications

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“…There is no established risk factor for delayed resolution of hydronephrosis following pyeloplasty. Carpenter et al [7] retrospectively studied complete resolution of hydronephrosis in children and found neither surgical approach nor presence of crossing vessel to significantly impact complete resolution [7]. Minnilo et al reported that 85% had improved hydronephrosis at follow-up after RALP [14].…”

Section: Discussionmentioning

confidence: 99%

“…Various definitions, based on scoring systems to grade hydronephrosis, or on the APD measured in millimeter or as relative improvement in percent, have impact on the results and may compromise comparisons. Carpenter et al [7] used APD Z 0 mm as the definition of complete resolution and concluded that complete resolution following pyeloplasty is uncommon. On the contrary, Rickard et al [17] used APD 15 mm to define resolution.…”

Section: Discussionmentioning

confidence: 99%

“…There is still a lack of knowledge regarding the natural course of resolution of hydronephrosis after pyeloplasty, and no consensus on how resolution of hydronephrosis is defined or when resolution is expected to occur [7,8]. Postoperative dilatation may resolve early or persist for long time [8].…”

Section: Introductionmentioning

confidence: 99%

“…Postoperative dilatation may resolve early or persist for long time [8]. This affects postoperative management and may lead to unnecessary examinations [7,10]. Consequently, follow-up routines vary considerably in terms of method, intervals and duration between different centers [9].…”

Section: Introductionmentioning

confidence: 99%

“…Few predictive factors for resolution of hydronephrosis following pyeloplasty have been identified and the uncertain prognosis may be distressing to parents and clinicians [7]. Hence, better evidence on how hydronephrosis resolves after pyeloplasty in children is needed.…”

Section: Introductionmentioning

confidence: 99%

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Resolution of hydronephrosis after pyeloplasty in children

Värelä

Omling

Börjesson

et al. 2021

Journal of Pediatric Urology

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Background There is still a lack of knowledge regarding the natural course of resolution of hydronephrosis after pyeloplasty, and no consensus exists on how resolution of hydronephrosis is defined or when resolution is expected to occur. Objective To determine when resolution of hydronephrosis occurs following pyeloplasty, by type of obstruction and by surgical approach. Methods This retrospective study included 125 children age <15 years treated with pyeloplasty and followed for two years with repeated ultrasound and MAG3 scan. Children with single kidneys, bilateral disease, and without hydronephrosis were excluded. Children with reinterventions were excluded in the evaluation of hydronephrosis but not in terms of success rate. Outcomes time to resolution of hydronephrosis (Anterior-Posterior diameter (APD) <10 mm or >50% reduction of APD) and 2-year success rate. Exposure was surgical approach and type of obstruction (intrinsic/extrinsic). Survival analysis was performed, adjusting for age, gender, year, laterality, preoperative renal function on MAG3, calyces dilatation and APD in the multivariable analysis. Results At 12 months and 24 months follow-up, 90% and 93% had reached resolution, respectively. All children with persistent dilatation had improved drainage and stable

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Resolution of hydronephrosis after pyeloplasty in children

Värelä

Omling

Börjesson

et al. 2021

Journal of Pediatric Urology

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Exploring the potential of the novel imidazole‐4,5‐dicarboxyamide chemical exchange saturation transfer scaffold for pH and perfusion imaging

Stabinska

et al. 2023

NMR in Biomedicine

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Here, we describe and assess the potential of 14 newly synthesized imidazole‐4,5‐dicarboxyamides (I45DCs) for pH and perfusion imaging. A number of these aromatic compounds possess large labile proton chemical shifts (up to 7.7 ppm from water) because of their intramolecular hydrogen bonds and a second labile proton to allow for chemical exchange saturation transfer (CEST) signal ratio‐based pH measurements. We have found that the contrast produced is strong for a wide range of substitutions and that the inflection points in the CEST signal ratio versus pH plots used to generate concentration‐independent pH maps can be adjusted based on these subsitutions to tune the pH range that can be measured. These I45DC CEST agents have advantages over the triiodobenzenes currently employed for tumor and kidney pH mapping, both preclinically and in initial human studies. Finally, as CEST MRI combined with exogenous contrast has the potential to detect functional changes in the kidneys, we evaluated our highest performing anionic compound (I45DC‐diGlu) on a unilateral urinary obstruction mouse model and observed lower contrast uptake in the obstructed kidney compared with the unobstructed kidney and that the unobstructed kidney displayed a pH of ~ 6.5 while the obstructed kidney had elevated pH and an increased range in pH values. Based on this, we conclude that the I45DCs have excellent imaging properties and hold promise for a variety of medical imaging applications, particularly renal imaging.

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