title: How does the presence of antenatally detected caliectasis predict the risk of postnatal surgical intervention?
abstract: OBJECTIVE
  To determine the effect of antenatally detected caliectasis on the postnatal surgical intervention rate.
  
  
  METHODS
  From 2006 to 2010, 56 patients with an anteroposterior diameter (APD) of 7-20 mm on the prenatal ultrasound scan performed in the third trimester of pregnancy were included in the present study. In these 56 patients, other anomalies (vesicoureteral reflux, posterior urethral valves, duplex system, megaureter) were excluded, and the postnatal clinical and radiologic follow-up data were available. The mean follow-up was 12.82 ± 10.72 months. These 56 patients were divided into 2 groups: those with (n = 32) and without (n = 24) caliectasis. In the caliectasis group, the mean follow-up was 13.6 ± 12.09 months and was 11.7 ± 8.70 months in the group without caliectasis. The statistical correlation between the postnatal operation rates and the presence of caliectasis (APD range 7-20 mm in third trimester) was investigated using the chi-square test.
  
  
  RESULTS
  In the study group (n = 56) with an APD range of 7-20 mm in the third trimester, postnatal surgical treatment (pyeloplasty) was performed in 12 (37.5%) and 3 (12.5%) of the children with and without caliectasis, respectively (P = .037). The risk of postnatal surgical treatment increased threefold in patients with an APD of 7-20 mm and a diagnosis of caliectasis (relative risk 3.0, 95% confidence interval 1.07-8.40).
  
  
  CONCLUSIONS
  In our study, the presence of concomitant caliectasis within the APD range of 7-20 mm on the third trimester ultrasound scan increased the risk of surgical treatment threefold. During prenatal counseling, the presence of caliectasis requires more rigorous follow-up.
authors.affiliation: Department of Urology, Division of Pediatric Urology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey. tayfuno@istanbul.edu.tr
authors.forename: Tayfun
authors.initials: T
authors.lastname: Oktar
authors.forename: Omer
authors.initials: O
authors.lastname: Acar
authors.forename: Arda
authors.initials: A
authors.lastname: Atar
authors.forename: Emre
authors.initials: E
authors.lastname: Salabas
authors.forename: Haluk
authors.initials: H
authors.lastname: Ander
authors.forename: Orhan
authors.initials: O
authors.lastname: Ziylan
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Kalelioglu
authors.forename: Recep
authors.initials: R
authors.lastname: Has
authors.forename: Atil
authors.initials: A
authors.lastname: Yuksel
mesh_terms: D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007670:Kidney Calices / Q000000981:diagnostic imaging* / Q000473:pathology; D011247:Pregnancy; D011379:Prognosis; D012306:Risk; D016216:Ultrasonography, Prenatal; D014517:Ureteral Obstruction / Q000601:surgery*