Pelvis/cortex ratio: An early marker of success following pyeloplasty in children

Babu, Ramesh; Sai, Venkata

doi:10.1016/j.jpurol.2009.12.004

Cited by 30 publications

(30 citation statements)

References 8 publications

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“…In the present study, patients with an APD of ≥20 mm were more likely to require surgery after the initial pyeloplasty. Although children with parenchymal thinning have a higher risk of impaired renal function [15-17], the value of parenchymal thickness was not significantly associated with the outcomes of contralateral hydronephrosis in our study.…”

Section: Discussioncontrasting

confidence: 70%

Predictive Factors of Contralateral Operation after Initial Pyeloplasty in Children with Antenatally Detected Bilateral Hydronephrosis Due to Ureteropelvic Junction Obstruction

Jiang¹,

Chen²,

Lin³

et al. 2018

Urol Int

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Objectives: This study was performed to analyze the predictive factors of a contralateral operation after initial pyeloplasty in patients with antenatally detected bilateral ureteropelvic junction obstruction. Methods: Patients with prenatally diagnosed bilateral ureteropelvic junction obstruction who underwent initial pyeloplasty (aged <12 months at initial pyeloplasty) were offered to participate in the study. Patients were recruited from January 2012 to December 2015. The anteroposterior renal pelvic diameter, parenchymal thickness, and calyceal dilatation were evaluated. Predictive factors of contralateral pyeloplasty after initial unilateral pyeloplasty were also examined. Results: In total, 82 patients were included in the study (mean age, 2.8 months). Among all patients who underwent initial pyeloplasty, additional contralateral pyeloplasty was required in 11 patients (13.4%). The outcome of contralateral hydronephrosis was assessed as resolution, persistence, or surgery. The median anteroposterior renal pelvic diameter and calyceal dilatation were significantly different among the groups (p < 0.001). Calyceal dilatation of ≥10 mm and a calyceal dilatation/parenchymal thickness ratio of ≥5 strongly suggested the likelihood of a contralateral operation. Conclusions: In most patients with bilateral ureteropelvic junction obstruction, improvement or resolution of contralateral hydronephrosis following initial unilateral pyeloplasty can be expected. Patients with contralateral calyceal dilatation >10 mm and the calyceal dilatation/parenchymal thickness ratio >5 are at higher risk of surgery.

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Section: Discussioncontrasting

confidence: 70%

Predictive Factors of Contralateral Operation after Initial Pyeloplasty in Children with Antenatally Detected Bilateral Hydronephrosis Due to Ureteropelvic Junction Obstruction

Jiang¹,

Chen²,

Lin³

et al. 2018

Urol Int

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“…Capolicchio et al [14] felt despite successful pyeloplasty, function recovery is minimal in kidneys with poor function and hydronephrosis diagnosed prenatally. Predicting the ones who are likely to deteriorate with the help of sonographic parameters such as pelvis cortex ratio [15,16] will avoid unnecessary surgery in the remainder. The findings of our study reveal that irrespective of initial SRF, early pyeloplasty in prenatally diagnosed SFU grade 3e4 PUJ obstruction leads to significant improvement of SRF, while delayed pyeloplasty leads to a marginal but significant loss.…”

Section: Discussionmentioning

confidence: 99%

Functional outcomes of early versus delayed pyeloplasty in prenatally diagnosed pelvi-ureteric junction obstruction

Babu

Rathish

Sai

2015

Journal of Pediatric Urology

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“…18,23 The success rate of open A-H dismembered pyeloplasty varies from 94 to 100% in different series. 2,3,12,15,18,21,23,30,31 Our success rate in both groups was nearly 100%. The outcome of repair regarding improvement of hydronephrosis and GFR was comparable in both groups (Table 3 and 4).…”

Section: Discussionmentioning

confidence: 66%

“…18,23,32 Some authors denied early improvement in hydronephrosis after pyeloplasty and described improvement from 6months to 1 year. 30,33,34 We followed up patients for a minimum of 3 months. However, some surgeons concluded that follow-up can be discontinued after 3 months.…”

Section: Discussionmentioning

confidence: 99%

A comparative study of outcome of pyeloplasty in stented and non-stented children

2019

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Background: It is a matter of debate whether to use a stent (double J) or not during pyeloplasty in patients of pelvic ureteric junction obstruction (PUJ obstruction). This study was conducted to assess which technique- stented or non-stented is better for paediatric patients with PUJ obstruction.Methods: 45 paediatric patients aged 0-12 years were included in this prospective comparative simple randomized sample study during the period of June 2015 to August 2017 in paediatric surgery division of department of surgery in M.Y. Hospital, Indore. All patients except one underwent open A-H dismembered pyeloplasty. The parameters used for comparison were renal parenchymal diameter, renal pelvis AP diameter, GFR (by DTPA scan) and rate of complications. Minimum follow up period was 3 months.Results: The M:F ratio was 2:1. Stented children had significant improvement in renal parenchymal diameter (i.e. increase) and GFR (of affected kidney) after pyeloplasty, whereas non-stented children too had improvement in renal parenchymal diameter and GFR (affected kidney) but was not significant. The percentage of postoperative complications were more in non-stented group as compared to stented group.Conclusions: In all paediatric cases with PUJO undergoing A-H pyeloplasty, both stenting and non-stenting have similar results and to place a double J stent should depend on choice of surgeon.

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Pelvis/cortex ratio: An early marker of success following pyeloplasty in children

Cited by 30 publications

References 8 publications

Predictive Factors of Contralateral Operation after Initial Pyeloplasty in Children with Antenatally Detected Bilateral Hydronephrosis Due to Ureteropelvic Junction Obstruction

Predictive Factors of Contralateral Operation after Initial Pyeloplasty in Children with Antenatally Detected Bilateral Hydronephrosis Due to Ureteropelvic Junction Obstruction

Functional outcomes of early versus delayed pyeloplasty in prenatally diagnosed pelvi-ureteric junction obstruction

A comparative study of outcome of pyeloplasty in stented and non-stented children

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