Ultrasound findings in children undergoing surgery during infancy for ureteropelvic junction obstruction with split renal function over 40 % − long-term results

2017 ◽  
Vol 16 (11) ◽  
pp. e2857
Author(s):  
J. Šarapatka ◽  
O. Šmakal ◽  
V. Študent
Keyword(s):  
Renal Function ◽  
Ureteropelvic Junction Obstruction ◽  
Ureteropelvic Junction ◽  
Long Term Results ◽  
Split Renal Function ◽  
Ultrasound Findings

Outcome of Percutaneous Nephrostomy in Children With Ureteropelvic Junction Obstruction

2020 ◽  
Vol 20 (2) ◽  
pp. 61-64
Author(s):  
Mohammad Mahfuzur Rahman Chowdhury ◽  
Rifat Zaman ◽  
Md Amanur Rasul ◽  
Akm Shahadat Hossain ◽  
Shafiqul Alam Chowdhury ◽  
...  
Keyword(s):  
Renal Function ◽  
Low Dose ◽  
Ureteropelvic Junction Obstruction ◽  
Percutaneous Nephrostomy ◽  
Ureteropelvic Junction ◽  
College Hospital ◽  
Medical College ◽  
Split Renal Function

Introduction and objectives: Congenital ureteropelvic junction obstruction (UPJO) is the most common cause of hydronephrosis. Management protocols are based on the presence of symptoms and when the patient is asymptomatic the function of the affected kidney determines the line of treatment. Percutaneous nephrostomy (PCN) became a widely accepted procedure in children in the 1990s. The aim of the study was to evaluate the results of performing percutaneous nephrostomy (PCN) in all patients with UPJO and split renal function (SRF) of less than 10% in the affected kidney, because the management of such cases is still under debate. Methods:This prospective clinical trial was carried out at Dhaka Medical College Hospital from January 2014 to December 2016. Eighteen consecutive patients who underwent PCN for the treatment of unilateral UPJO were evaluated prospectively. In these children, ultrasonography was used for puncture and catheter insertion. Local anesthesia with sedation or general anesthesia was used for puncture. Pig tail catheters were employed. The PCN remained in situ for at least 4 weeks, during which patients received low-dose cephalosporin prophylaxis. Repeat renography was done after 4 weeks. When there was no significant improvement in split renal function (10% or greater) and PCN drainage (greater than 200 ml per day) then nephrectomies were performed otherwise pyeloplasties were performed. The patients were followed up after pyeloplasty with renograms at 3 months and 6 months post operatively. Results: All the patients had severe hydronephrosis during diagnosis and 14 patients with unilateral UPJO were improved after PCN drainage and underwent pyeloplasty. The rest four patients that did not show improvement in the SRF and total volume of urine output underwent nephrectomy. In the patients with unilateral UPJO who improved after PCN drainage, the SRF was increased to 26.4% ±8.6% (mean± SD) after four weeks and pyeloplasty was performed. At three and six months follow-up, SRF value was 29.2% ±8.5% and 30.8.2% ±8.8% respectively. Conclusion: Before planning of nephrectomy in poorly functioning kidneys (SRF < 10%) due to congenital UPJO, PCN drainage should be done to asses improvement of renal function. Bangladesh Journal of Urology, Vol. 20, No. 2, July 2017 p.61-64

scholarly journals Dynamic Renal Scintigraphy Results of Pediatric Patients Operated Due to Unilateral Ureteropelvic Junction Obstruction: A Novel Approach to Overestimated Ipsilateral Differentiated Renal Function

2021 ◽  
Author(s):  
Sabri Cansaran ◽  
Ayşenur Celayir ◽  
Serdar Moralıoğlu ◽  
Osman Zeki Pektaş ◽  
Oktav Bosnalı
Keyword(s):  
Renal Function ◽  
Ureteropelvic Junction Obstruction ◽  
Ureteropelvic Junction ◽  
General Group ◽  
Factors Affecting ◽  
Novel Approach ◽  
Ultrasound Findings ◽  
The Mean ◽  
The Difference ◽  
Anterior Posterior

Objective: The aim of this study was to scintigraphically investigate the preoperative and postoperative renal functions of patients operated due to ureteropelvic junction obstruction, discuss the factors affecting the indication of surgery and emphasize the important points to consider during scintigraphic examination. Method: We retrospectively analyzed pediatric cases who underwent pyeloplasty due to ureteropelvic junction obstruction. Patients operated for primary ureteropelvic junction obstruction whose preoperative and postoperative dynamic scintigraphy results could be obtained were included in the study. The patients were divided into two groups as those with <50% and ≥50% ipsilateral differentiated renal function. The difference between the groups was considered statistically significant when p<0.05. Results: The median ages of 36 cases in <50% DRF group and 24 cases in ≥50% DRF group were 7.7 months and 8.5 months, respectively. The mean ipsilateral differentiated renal function values of the main groups were significantly different from each other both in the preoperative and postoperative periods. The changes within the two main groups were also analyzed, yielding significant differences. Ipsilateral differentiated renal function changes on a general, group and subgroup basis, and preoperative ultrasound findings of the ipsilateral kidney in subgroups were revealed. Conclusion: Increased hydronephrosis degree and renal pelvis anterior-posterior diameter are closely related to overestimated ipsilateral kidney function. For deciding on surgery in patients with ureteral obstruction, scintigraphic examinations make sense with the help of US and the clinical condition of the patient.

Laparoscopic pyeloplasty for secondary ureteropelvic junction obstruction: Long-term results

2015 ◽  
Vol 22 (4) ◽  
pp. 368-371 ◽  
Author(s):  
Morihiro Nishi ◽  
Mayumi Tsuchida ◽  
Masaomi Ikeda ◽  
Daisuke Matsuda ◽  
Masatsugu Iwamura
Keyword(s):  
Ureteropelvic Junction Obstruction ◽  
Ureteropelvic Junction ◽  
Long Term Results ◽  
Laparoscopic Pyeloplasty

scholarly journals Evaluation of Renal Function After Percutaneous Nephrostomy in Obstructive Uropathy Due to Ureteropelvic Junction Obstruction

2020 ◽  
Vol 17 (1) ◽  
pp. 36-41
Author(s):  
Md Faisal Islam ◽  
SM Mahbub Alam ◽  
Md Babrul Alam ◽  
MA Awal ◽  
Md Amanur Rasul
Keyword(s):  
Renal Function ◽  
Specific Gravity ◽  
Filtration Rate ◽  
Ureteropelvic Junction Obstruction ◽  
Obstructive Uropathy ◽  
Percutaneous Nephrostomy ◽  
Ureteropelvic Junction ◽  
Upj Obstruction ◽  
Split Renal Function ◽  
The Mean

Objective: The present prospective study was conducted to evaluate the renal function after percutaneous nephrostomy (PCN) in obstructive uropathy due to ureteropelvic junction obstruction. Patients of UPJ obstruction irrespective of sex upto 15 years of age and split renal function (SRF) of the affected kidney <10% were enrolled in the study. Methods: The present prospective study was carried out at the Department of Urology, Dhaka Medical College Hospital from January 2007 to December 2008. The patients having ureteropelvic junction (UPJ) obstruction with poor renal function were the study population. Patients of either sex up to 15 years of age and split renal function < 10% (unilateral and / bilateral) were enrolled in the study. Patients with other anatomical abnormality of urinary system, concomitant pathologies like stone, pyonephrosis or previous surgical intervention of kidney and/or ureter were excluded from the study. Baseline variables were flank mass, flank pain, side of hydronephrosis, split renal function (SRF), glomerular filtration rate (GFR), specific gravity of urine at the time of PCN. Postoperative follow up variables (at 2, 4 and 6 weeks) were split renal function (SRF), glomerular filtration rate (GFR), specific gravity urine draining through nephrostomy tube, volume of urine through nephrostomy tube and complications. Data were collected using a structured questionnaire (research instrument) containing all the variables of interest. Data were processed and analysed using SPSS (Statistical Package for Social Sciences). The test statistics used to analyse the data were descriptive statistics and Repeated measure ANOVA. For all analytical tests, the level of significance was set at 0.05 and p < 0.05 was considered significant. Result: The mean age of the patients was 8.6 ± 3.9 years and the lowest and highest ages were 3 months and 15 years respectively. The poorly functioning kidneys demonstrated a steady increase in SRF from 3.6% at baseline to 23% after 6 weeks PCN (p < 0.001). SRF of all children except 4 improved significantly during the period. The mean GFR of poorly functioning kidneys was 3.5ml/min/1.73 sq-meter at baseline which increased to 28.4 ml/min/1.73 sq-meter at the end of week 6. The GFR of 34 children improved (> 10 ml/min/1.73 sq-meter at the 6 week of treatment. Four cases (10.5%) did not improve. The specific gravity of urine significantly increased from 1.009 at baseline to 1.019 after 6 weeks. The volume of urine at 2nd week was 338 ml/24hour which sharply increased to 363 ml/24 hours at week 4 and nearly 386 ml/24hours after 6 weeks of PCN (p < 0.001). Conclusion: Present study recommends that as the likelihood of recovery of a severely damaged kidney (SRF < 10%) with UPJO following PCN is fairly satisfactory; none of the children with poorly functioning kidney should undergo nephrectomy without subjecting them to a PCN trial. Bangladesh Journal of Urology, Vol. 16, No. 1, Jan 2014 p.36-41

Laparoscopic pyeloplasty for management of ureteropelvic junction obstruction: long-term results

2002 ◽  
Vol 1 (1) ◽  
pp. 58 ◽  
Author(s):  
Reinhard Peschel ◽  
Richard Neururer ◽  
Petrovic Alexander Scheidel ◽  
Matthew Gettman ◽  
Georg Bartsch
Keyword(s):  
Ureteropelvic Junction Obstruction ◽  
Ureteropelvic Junction ◽  
Long Term Results ◽  
Laparoscopic Pyeloplasty
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