Moderate approach to the antenatally diagnosed unilateral ureteropelvic junction obstruction: experience with 93 patients.
To evaluate the results of the treatment in patients with antenatally detected unilateral ureteropelvic junction obstruction. Ninety-three patients were analyzed according to the radiologic and scintigraphic findings and mode of the treatment. Fifty-eight patients were treated surgically while 29 patients were followed conservatively. All patients were reevaluated at the first year of the treatment with diuretic renogram (DR). Follow-up procedure was finished at first postoperative year in surgically treated patients, while mean follow-up duration was 14.9+/-6.9 months for the conservatively treated group. In the operated group, pelvic diameter was greater than 20 mm on ultrasound and overall rate of mean split renal function was 38.65+/-9.55% on DR and 39.65+/-12.55% at first postoperative year. In the conservatively treated group, mean split renal function was 46.17+/-3.42 at the beginning and 47.48+/-4.00 at first year of follow-up. Sixty-three percent of the patients underwent pyeloplasty while 83% of them were showing obstructive pattern on DR. We believed that surgery should be done in renal units which showed pelvic diameter greater than 20 mm and less than 40% of split renal function, while others might be followed conservatively, with or without an obstructive pattern on DR.
Tireli
G A
GA
Department of Pediatric Surgery, Bakirkoy Maternity and Children's Hospital, Istanbul, Turkey. gultireli@yahoo.com
Eliçevik
M
M
Demirali
O
O
Unal
M
M
Sander
S
S
D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging / Q000601:surgery*