Ureteropelvic Junction Obstruction: Long-Term Followup of Adults With and Without Surgical Treatment

Kinn, Anne‐Charlotte

doi:10.1097/00005392-200009010-00009

Cited by 21 publications

(23 citation statements)

References 21 publications

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“…Our series reported nephrectomy in 37.1% of the patients (42.1% in adults and 31.25% in children) which is comparable to 33% reported by Sataa et al [21] and Crooks et al [8] . Our study highlighted the higher rate of nephrectomy in GH compared to simple HDN (37.1% vs. 05%) comparable to that reported by Kinn et al [22] Hence this study highlights the need for early diagnosis and management in GH.…”

Section: Discussionsupporting

confidence: 85%

Giant hydronephrosis: still a reality!

Kaura

Kumar

Sokhal

et al. 2017

Turkish Journal of Urology

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Objective: Giant hydronephrosis (GH) is a rare entity in both developed and developing countries with less than 500 cases reported in the literature. Delayed diagnosis and management of GH, can result in long-term complications like hypertension, rupture of the kidney, renal failure and malignant change. We aim to highlight the importance of this often neglected entity and build a consensus for its early diagnosis and management. Material and methods:Patients with GH were thoroughly worked up, managed and followed up between June 2013 and December 2015 and epidemiologic, radiological, perioperative and follow-up data was recorded.Results: A total of 35 patients (adults and children) were reported. Flank pain in adults and abdominal lump in children were the most common clinical presentation. Percutaneous nephrostomy tube was placed in all patients and detailed work up was done to reach final diagnosis. Pelvi-ureteric junction obstruction (PUJO) was the final diagnosis in 32 patients (91.4%). Kidneys were non-functioning in 13 cases (37.1%) so nephrectomies were performed. Reduction pyeloplasty with nephropexy was done in 21 patients (60%) with 81% success and 23.1% complication rates. Conclusion:GH requires early diagnosis and management to prevent higher nephrectomy rate along with poor success rate of conservative surgery like pyeloplasty.

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Section: Discussionsupporting

confidence: 85%

Giant hydronephrosis: still a reality!

Kaura

Kumar

Sokhal

et al. 2017

Turkish Journal of Urology

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“…12 Although the split renal function improved slightly, total renal function did not change during a mean of 17 years follow up. Since hydronephrosis appears to be a stable condition in the absence of infectious complications, he emphasized the need for a well designed randomized clinical trial to compare surgical management with conservative nonintervention.…”

Section: Discussionmentioning

confidence: 90%

Retrograde ureteroscopic endopyelotomy using the holmium:YAG laser

et al. 2002

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Background : We report our experience of retrograde ureteroscopic endopyelotomy using the holmium laser for ureteropelvic junction (UPJ) obstruction not associated with upper tract stones. Methods : We carried out this procedure on five patients through an 8-Fr semirigid ureteroscope. The ureter was not stented before the procedure and balloon dilation was not necessary before retrograde insertion of the ureteroscope. The obstruction was incised with the holmium laser using a 200 µ m fiber in a linear fashion. After completion of the incision, a 12-Fr double-J ureteral stent was left for 6 weeks. Thereafter, patients were monitored with renal scan and/or ultrasound and excretory urography at 3-6 month intervals.Results : Hydronephrosis was obviously improved in four cases (80%) at an average follow up of 12.8 months (4-23 months). Although the number of treated patients was small, retrograde ureteroscopic endopyelotomy for UPJ obstruction using the holmium laser achieved good results. Conclusions : We recommend that this procedure be used initially because it is less invasive and has a favorable outcome.

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“…Nephrectomy or renal vascular embolisation may eventually be required to either resolve or prevent such complications. (1)(2)(3)(4) For this reason, evaluation of the residual function of an obstructed kidney is necessary in determining the proper management of such patients.…”

Section: Introductionmentioning

confidence: 99%

Excretory urography and renal scintigraphy for chronic obstructed kidney: does nonopacity mean nonsalvageability?

Klaipetch¹,

Namwongprom²,

Ekmahachai³

et al. 2013

smedj

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RESULTSThe results of IVU and renal scintigraphy findings for 34 (75.6%) nonopacified kidneys matched, representing nonsalvageable kidneys. Sensitivity and specificity of differential renal function were 76% and 100%, respectively, when the cutoff point for non-function was set at < 15%. Sensitivity and specificity were 97% and 82%, respectively, when the cutoff point was < 20%. There was no significant difference between renal scintigraphy findings and IVU with 2-hour and > 2-hour delayed films (p = 0.96).CONCLUSION Although most nonopacified kidneys on IVU were nonsalvageable, a quarter of them were found to be salvageable on renal scintigraphy. Besides split GFR, differential function at cutoff point < 15% could be used to determine non-function of a chronic obstructed kidney when the contralateral kidney is normal. Delayed filming beyond two hours appears unnecessary in ensuring non-excretion on IVU.

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Ureteropelvic Junction Obstruction: Long-Term Followup of Adults With and Without Surgical Treatment

Abstract: In the absence of infection and stone formation hydronephrosis in adults seems to be a fairly benign condition and followup should be directed mainly toward detecting these complications. Recurrent flank pain still seems to be the best indication of the need for surgery.

Cited by 21 publications

References 21 publications

Giant hydronephrosis: still a reality!

Giant hydronephrosis: still a reality!

Retrograde ureteroscopic endopyelotomy using the holmium:YAG laser

Excretory urography and renal scintigraphy for chronic obstructed kidney: does nonopacity mean nonsalvageability?

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