Pelviureteric Obstruction in Children: The Effect of Pyeloplasty on^99mTc-DTPA Uptake and Washout

Abstract

The renographies of 23 children, treated by means of dismembered pyeloplasty for unilateral pelviureteric obstruction, were analysed. Computerised 99mTc-DTPA renography was performed on each patient both preoperatively and on one or several occasions postoperatively. Of the 13 hydronephrotic kidneys, which had normal glomerular function preoperatively, 12 had also normal postoperative function. In a large proportion of those hydronephrotic kidneys which had reduced glomerular function preoperatively, the function improved after pelviureteroplasty. The improvement was most pronounced in the group of kidneys with severely reduced preoperative glomerular function. The effect of pelviureteroplasty on the washout of DTPA was examined in 13 patients who had diuretic renograms performed both preoperatively and postoperatively. Improved drainage of the hydronephrotic kidney after pyeloplasty was noticed in all these cases.

Long-term results of pyeloplasty in poorly functioning kidneys in the pediatric age group

“…They observed that hydronephrotic kidneys that had reduced glomerular function preoperatively improved after pyeloplasty. The improvement was more pronounced in the group of kidneys with severely reduced preoperative glomerular function [16].…”

Renal Recovery after Release of Experimental Neonatal Ureteric Obstruction

“…Postoperative renal function has been studied less extensively and with conflicting results. Some inves tigators found no change in renal function after pyeloplasty [17,18], whereas others found an improvement [11,15,23], maximal already after 1-2 weeks [27], Experimental studies of renal function after release of partial ureteric obstruction, the most common type in children, have been performed only in adult animals. A moderate improvement, maximal within 6 weeks, was observed [ 13].…”

Outcome analysis of immediate and delayed laparoscopic pyeloplasty in infants with severe ureteropelvic junction obstruction

“…Most controversially, whether these patients should be aggressively treated with surgery or conservatively observed. The main goal in the treatment of UPJO is to preserve or improve renal function ( 19 , 20 ), we stressed no difference that conservative management of some patients with antenatally detected severe UPJO probably results in irreversible loss of function ( 21 ) and followed up with this study, which showed that immediate laparoscopic pyeloplasty accelerated the recovery of renal morphology in infants with severe UPJO-induced hydronephrosis. Immediate surgical intervention is effective and should be performed during this period.…”