Antenatally detected pelviureteric junction obstruction. Is non-operation safe?
We report follow-up data (minimum of 1 year) on 63 kidneys with antenatally detected pelviureteric junction obstruction, as defined by renographic criteria. The condition was bilateral in 10 patients (i.e. 20 kidneys), 2 patients had unilateral obstruction with contralateral multicystic dysplastic kidneys, and 41 patients had unilateral obstruction with a normal contralateral kidney. In the latter group, 29 (71%) had good function (greater than 40%) at initial assessment. Of the 63 kidneys, 24 (38%) were operated upon following initial assessment, mainly for impaired function. Of 39 patients, initially managed non-operatively, 8 (21%) were operated upon subsequently: 3 for deteriorating function (2 of whom have been reassessed and both have regained their lost function) and 5 for other renographic or ultrasonic indications). Of the original 63 kidneys, 31 (49%) continue to be managed non-operatively; 16 of these (52%) show improving ultrasound appearances, 8 of 17 studied show improved drainage, and all unilateral cases have stable good function. It is concluded that non-operative management of selected cases of antenatally detected pelviureteric junction obstruction is safe.
Madden
N P
NP
Department of Paediatric Surgery, St James's University Hospital, Leeds.
Thomas
D F
DF
Gordon
A C
AC
Arthur
R J
RJ
Irving
H C
HC
Smith
S E
SE
D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D006801:Humans; D007231:Infant, Newborn; D007668:Kidney / Q000000981:diagnostic imaging / Q000503:physiopathology; D007682:Kidney Pelvis; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011379:Prognosis; D011866:Radioisotope Renography; D014517:Ureteral Obstruction / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*