Diuretic renography in hydronephrosis: a retrospective single-center study

Kandur, Yaşar; Salan, Ahmet; Güler, Ahmet Gökhan; Tuten, Fatih

doi:10.1007/s11255-018-1893-y

Cited by 16 publications

(15 citation statements)

References 28 publications

(31 reference statements)

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“…Moreover, clinical variables of the enrolled patients, such as age, sex, weight, operating side of UPJO and hydronephrosis, hospital stay, duration of surgery, and complications in double-J stent placement, were collected and independently reviewed by two authors (Haobo Zhu and Jun Wang). The inclusion criteria for the patients were as follows: (1) patients diagnosed with congenital unilateral or bilateral UPJO with severe hydronephrosis (Grades II, III, and IV) as confirmed by ultrasound and/or nuclear scan; (2) patients aged between 0 and 17 years; (3) patients who had undergone LP procedures and insertion of double-J stents post-surgery; and (4) patients who volunteered to be included in this study.…”

Section: Patientsmentioning

confidence: 99%

“…1 Congenital UPJO serves as a prime indicator during the pathogenesis of hydronephrosis, which is an ailment that is twice as common in boys than in girls. 2 Moreover, hydronephrosis caused by UPJO can lead to progressive renal impairment and further renal failure if left untreated. 3 Open pyeloplasty (OP) is considered the gold standard treatment for UPJO with a > 90% success rate.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Use of double-J ureteric stents post-laparoscopic pyeloplasty to treat ureteropelvic junction obstruction in hydronephrosis for pediatric patients: a single-center experience

et al. 2020

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Objectives We aimed to investigate the safety concerns associated with placing double-J ureteric stents post-laparoscopic pyeloplasty surgery for congenital ureteropelvic junction obstruction (UPJO) and hydronephrosis. Methods A total of 1349 patients with postoperative double-J stent placement at our center were included. Clinical variables for enrolled patients were collected by two independent authors. We compared clinical variables and the efficacy of stenting post-laparoscopic pyeloplasty. Results The mean age of the patients was 4.23 ± 2.39 years. A total of 58.49% of patients were diagnosed with left UPJO with hydronephrosis and 33.95% were diagnosed with right UPJO. Furthermore, 7.56% of patients had bilateral UPJO. In all cases, 96.96% of indwelling double-J stents were successfully removed 4 weeks post-surgery. A total of 3.04% of the patients still required further management, including stent migration to the renal pelvis (0.37%), stent migration to the bladder (0.30%), prolapse of the stent through the ureter (0.15%), blockage of stents (1.85%), and fouling of stents (0.37%). Conclusions Double-J ureteric stents used after laparoscopic pyeloplasty for treating UPJO in hydronephrosis for pediatric patients is a safe, feasible, and beneficial method, which can be recommended for routine procedures. However, caution should be practiced for follow-up and removal using this method.

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Section: Patientsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Use of double-J ureteric stents post-laparoscopic pyeloplasty to treat ureteropelvic junction obstruction in hydronephrosis for pediatric patients: a single-center experience

et al. 2020

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“…An APD of 15-30 mm is an indication for a close follow-up (15). Kandur et al (16) reported that an APD threshold of 20 mm can be used for predicting future obstruction and a low differential renal function (DRF). However, they showed that an APD of 15 mm was not a risk factor for a future low DRF.…”

Section: Discussionmentioning

confidence: 99%

The Course of Congenital Hydronephrosis in Infancy

Tursun¹,

Alpcan²,

Kandur³

et al. 2021

Turkish Journal of Pediatric Disease

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Objective: The aim of our study is to examine the spontaneous resolution rates of congenital hydronephrosis from a recent perspective.Material and Methods: Sixty-nine pediatric patients (M/F=46/23) with congenital hydronephrosis were enrolled in this study. Results:The mean age at the first postnatal examination was 10.8±7.6 days, and the mean age at the time of the final examination was 9.5±3.2 months. Forty-eight patients' renal anteroposterior diameters (APD) (69.5%) improved while 8 (11.6%) patients' APDs worsened during the follow-up period. However, MAG3 of these 8 patients was normal. The remaining thirteen (18.9%) patients had congenital anomalies of the kidney and the urinary tract (8 vesicoureteral reflux, 5 cases of ureteropelvic junction obstruction). The mean baseline APD was 9.1±2.8 mm in the group with reduced APD, and 9.7±2.8 mm in the one with increased APD (p=0.461). The mean APD at the final visit was significantly lower in the group with reduced APD than that in the group with increased APD (5.1±1.8 mm vs 17.9±12.6 mm; p=0.001). The anteroposterior diameter of 26 (81.25%) patients with left-sided hydronephrosis and 10 (71.4%) patients with rightsided hydronephrosis regressed spontaneously. The rate of spontaneous resolution was relatively low in patients with bilateral hydronephrosis (n=13; 56.5%) compared to unilateral ones. Conclusion:Our study indicates that an initially mild hydronephrosis does not exclude a pathological course in cases of congenital hyronephrosis. Therefore, in such patients, routine ultrasonography should be done regularly.

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“…Fetal AD, SFU grade (3–4) and AD parenchyma thickness ratio can be considered as the earliest instruments to indicate surgery [25,26]. Postnatal ultrasound cut-off values for renal obstruction on DRS have been suggested to be 15–20 mm AD [27]. Onen’s alternative grading system, of grades 3 or 4 with no jets on a Doppler scan, increased sensitivity to 78.9% and accuracy to 92% in diagnosing obstruction [28].…”

Section: Discussionmentioning

confidence: 99%

Diuretic Enhanced Ultrasonography in the Diagnosis of Pyeloureteral Obstruction

et al. 2019

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Background and Objectives: To determine the value of diuretic ultrasonography for the diagnosis of obstructive hydronephrosis. Materials and Methods: Diuretic enhanced ultrasonography was used routinely as a part of examination of patients with hydronephrosis in our Department. There were 72 patients (42 males, 30 females; aged 2 months to 17 years; median age 7.07 years) with a sonoscopic diagnosis of hydronephrosis included from January 2006 until October 2011. The anteroposterior diameter (AD) of renal pelvis was measured sonoscopically before and at sixty minutes after furosemide injection. A weight-adjusted dose of 1 mg/kg of furosemide was administered intravenously. Results: Patients were operated on if pyeloureteral obstruction was suspected because of low or deteriorating differential renal function, increasing hydronephrosis or symptoms thereof. Hydronephrosis was unilateral in 61 (84.7%) and bilateral in 11 (15.3%) patients. The median AD of pelvis before furosemide injection was 22 mm in operated and 17 mm in non-operated patients (p = 0.005). Sixty minutes after furosemide injection, the AD of pelvis in operated patients was 35.5 mm and 25.8 mm in non-operated—25.8 mm (p < 0.001). Logistic regression model demonstrated that significant factors for surgery were: AD 60 min after furosemide infection and ultrasonographic parenchymal sclerosis. Conclusion: Ultrasound measurement of the AD of renal pelvis 1 h after the injection of furosemide used as an additional investigation can help in predicting obstructive hydronephrosis.

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Diuretic renography in hydronephrosis: a retrospective single-center study

Cited by 16 publications

References 28 publications

Use of double-J ureteric stents post-laparoscopic pyeloplasty to treat ureteropelvic junction obstruction in hydronephrosis for pediatric patients: a single-center experience

Use of double-J ureteric stents post-laparoscopic pyeloplasty to treat ureteropelvic junction obstruction in hydronephrosis for pediatric patients: a single-center experience

The Course of Congenital Hydronephrosis in Infancy

Diuretic Enhanced Ultrasonography in the Diagnosis of Pyeloureteral Obstruction

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