[The preoperative function of the affected kidney and the outcome of endopyelotomy for ureteropelvic junction obstruction].
Between July 1988 and February 1998, we treated 132 patients with 133 procedures of endopyeloureterotomy via the transpelvic extraureteral approach and followed them up for more than one year. Of 9 unsuccessful cases, 4 were confirmed to have the patency of the stenotic segment on retrograde pyeloureterograms. We compared these 4 cases with another 4 cases which were subsequently treated successfully despite poor renal function. Pre- and post-operative changes in renal function in 8 cases with unilateral hydronephrosis due to ureteropelvic junction obstruction were studied based on 99mTc-DMSA renal uptake rate and creatinine clearance. In successful cases, DMSA renal uptake rates compared with the healthy side were 9% to 59%. Unilateral creatinine clearance was 6 to 34 ml/min. All cases were improved slightly in renal function. In unsuccessful cases, DMSA the renal uptake rate was 2% to 89% and creatinine clearance 10 to 16 ml/min. No improvement in renal function was noted. Patients with differential renal function of less than 20 ml/min would thus appear to have little chance of postoperative improvement of differential function.
Yamada
S
S
Department of Urology, Okazaki Shimin Hospital.
Ono
Y
Y
Ohshima
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000150:complications; D007668:Kidney / Q000503:physiopathology*; D007677:Kidney Function Tests; D007682:Kidney Pelvis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*