Pelvis/cortex ratio: an early marker of success following pyeloplasty in children.
OBJECTIVE
To document the change in anterio-posterior pelvic diameter (APPD), cortical thickness (CT) and pelvis/cortex ratio (P/C ratio) following pyeloplasty, and determine the usefulness of each of these parameters in assessing postoperative outcome.


METHODS
Twenty-four children with unilateral pelvi-ureteric junction obstruction who underwent standard dismembered pyeloplasty with stent were prospectively studied (median age 13 months; range 2 months-5 years). Maximum APPD, CT and P/C ratio values were compared pre- and postoperatively.


RESULTS
Mean APPD was 40.70 mm preoperatively, and 30.04 mm at 3 months and 12.75 mm at 1 year postoperatively. The reduction in size at 3 months was not significant (P = 0.34), but was significant at 1 year (P < 0.01). Mean CT was 4.41 mm preoperatively, 6.29 mm at 3 months and 9.45 mm at 1 year. The increase in CT was not significant at 3 months (P = 0.44), but was significant at 1 year (P < 0.01). The P/C ratio was 13.48 mm preoperatively, 5.73 mm at 3 months and 1.45 mm at 1 year. The reduction in P/C ratio was significant at 3 months (P < 0.01) as well as at 1 year (P < 0.01). Sonographic resolution rate did not correlate with outcomes on radionuclide scans.


CONCLUSIONS
P/C ratio could be used as an early marker of success following pyeloplasty. Improvement in other sonographic criteria or on radionuclide scans may be useful only in the long term.
Babu
Ramesh
R
Department of Pediatric Urology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra University, Porur, Chennai 600116, India. drrameshbabu1@dataone.in
Sai
Venkata
V
D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007672:Kidney Cortex / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D007682:Kidney Pelvis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D011446:Prospective Studies; D011859:Radiography; D011877:Radionuclide Imaging; D015607:Stents; D016896:Treatment Outcome; D014463:Ultrasonography; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*