title: Successful early pyeloplasty in infants.
abstract: BACKGROUND
  Early pyeloplasty for the treatment of congenital ureteropelvic junction obstruction to maximize nephron salvage is justified only if potential hazards of operating on small infants are avoided.
  
  
  METHODS
  The records were analyzed of all infants who underwent pyeloplasty over a 5-year period. Open pyeloplasty was performed if collecting systems had deteriorated or were demonstrated to be obstructed; it was also performed for severe cases of hydronephrosis. Outcome of surgery in the younger infant (patients <2 months of age) was compared with the older infant group (patients >2 months of age). Preoperative evaluation in case of mild or moderate hydronephrosis was directed toward ruling out a non-obstructed collection system and included voiding cystourethrography, and serial ultrasonography and/or dual isotope diuretic renography. Postoperative assessment consisted of serial ultrasonography and/or nuclear imaging to confirm decompression and relief of obstruction.
  
  
  RESULTS
  A total of 24 pyeloplasties were performed on 22 patients in the younger infant group (two bilateral) and 30 were performed on 27 infants in the older infant group (three bilateral). The only significant differences between the groups were as follows: patients in the younger infant group were likely to present in utero (75%, p = 2.69), whereas those in the older infant group were more likely to present with a urinary tract infection (48%, p = 4.12). During follow-up examination, 23 renal units in the younger infant group and 24 in the older infant group were judged to be stable or improved. Four kidneys were not salvaged after pyeloplasty, one in the younger infant group and three in the older infant group.
  
  
  CONCLUSIONS
  Good results of pyeloplasties performed in the infants in this series support early correction of ureteropelvic junction obstruction in infants.
authors.affiliation: Department of Pediatric Surgery, University Hospital Renbro, Kispaticeva #12, Zagreb, 10000 Croatia. anko.antibak@zg.tel.hr
authors.forename: Bozidar
authors.initials: B
authors.lastname: Zupancic
authors.forename: Anko
authors.initials: A
authors.lastname: Antabak
authors.forename: Ljiljana
authors.initials: L
authors.lastname: Popovic
authors.forename: Vera
authors.initials: V
authors.lastname: Zupancic
authors.forename: Josip
authors.initials: J
authors.lastname: Cavcic
authors.forename: Mate
authors.initials: M
authors.lastname: Majerovic
authors.forename: Stipe
authors.initials: S
authors.lastname: Batinica
authors.forename: Ranka P
authors.initials: RP
authors.lastname: Sern
authors.forename: Mirjana
authors.initials: M
authors.lastname: Poropat
authors.forename: Tomislav
authors.initials: T
authors.lastname: Leutic
mesh_terms: D000367:Age Factors; D000818:Animals; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D007223:Infant; D007231:Infant, Newborn; D007668:Kidney / Q000000981:diagnostic imaging; D007682:Kidney Pelvis / Q000601:surgery*; D008297:Male; D011247:Pregnancy; D014463:Ultrasonography; D014517:Ureteral Obstruction / Q000150:complications / Q000601:surgery*