Imaging in children with unilateral ureteropelvic junction obstruction: time to reduce investigations?

Abadir, Nadin; Schmidt, Michael; Laube, Guido F.; Weitz, Marcus

doi:10.1007/s00431-017-2966-0

Cited by 7 publications

(3 citation statements)

References 19 publications

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“…Duong et al [21] evaluated 81 children with ureteropelvic junction stenosis, they showed that DRF was impaired in patients with renal pelvis ap diameter > 30 mm, calyx dilatation > 10 mm, parenchymal thinning, and they drew attention to the importance of performing a scintigraphic examination in these patients. Similarly, Abadir et al [22] argued that there is no need for further investigation in patients with an AP diameter of < 15 mm and without an increase in HN stage on serial US. In a recent study, a new scoring system was developed for UPJO-like HN, and it was determined that this system, based on both SFU staging, renal pelvis AP diameter measurement, and kidney size, can very sensitively identify patients who will require surgery.…”

Section: Discussionmentioning

confidence: 99%

Long Term Follow-Up Of Patients With Nonrefluxing Hydronephrosis

Yılmaz,

Özçakar,

Cakar

et al. 2023

Klin Padiatr

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Backgound The aim of this study is to examine the long-term prognosis of children with ureteropelvic junction obstruction-like hydronephrosis (UPJO-like HN). Patients and Methods The files of children with hydronephrosis (HN) were analyzed retrospectively. Patients with vesicoureteral reflux (VUR) and other genitourinary anomalies were excluded. The final status of the HN, the need for surgery, and urinary tract infection (UTI) frequency were evaluated. Results The study included 219 patients with 302 renal units (RU) with HN. Surgery rate was higher in RUs with larger kidney size and parenchymal thinning (p:<0.001 for both). Hydronephrosis resolved in 113 (40.2%) RUs, improved in 66 (23.3%), unchanged in 100 (35.5%) and worsened in 4 (1.4%). The frequency of recovery and improvement was found to be less in RUs with severe HN, large kidney size, and thin parenchyma. The UTI frequency was higher in severe HN group (12.2% vs 30.6% p:<0.001). Conclusions Children with mild HN had an excellent prognosis. Although the majority of the patients with high-grade HN had also a good prognosis, it seems important to closely follow up patients with severe HN, increased kidney size, and accompanying parenchymal thinning. Clinicians should be aware of the increased frequency of UTIs in children with severe HN.

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Section: Discussionmentioning

confidence: 99%

Long Term Follow-Up Of Patients With Nonrefluxing Hydronephrosis

Yılmaz,

Özçakar,

Cakar

et al. 2023

Klin Padiatr

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“…Functionally significant obstruction is often diagnosed with diuretic renal scanning with no washout of isotope even after Lasix. Poorly functioning kidneys (<10% GFR) are often best treated with nephrectomy [7][8][9]. Complications of PUJO are recurrent urinary tract infection, chronic loin pain, formation of secondary renal stones, and partial or complete loss of kidney function.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic management of pelvi-ureteric junction obstruction caused by aberrant renal vessels in an adult

Sangoi¹,

Shetty²,

Joshi³

2022

Indian J Case Reports

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Pelvi-ureteric junction obstruction is not a rare clinical entity. It is indeed one of the common urological conditions presenting most commonly as hydronephrosis and pain. The most common etiology for patients suffering from acquired pelvi-ureteric junction obstruction is the presence of calculus/calculi. An aberrant renal vessel (now termed as Vascular bar) is one of the causes in adults which is often missed on pre-operative investigations and is detected intra-operatively. We present herein, a case report of a 28 years old female who came with complaints of loin pain since 2 to 3 months. The workup investigations revealed only hydronephrosis without any calculi. Thus a diagnosis of primary pelvi-ureteric junction obstruction was made. The patient was successfully managed by a laparoscopic pyeloplasty. Keywords : PUJ obstruction, Vascular bar, aberrant renal vessel, laparoscopic pyeloplasty

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“…Optimal follow-up of children after pyeloplasty have been discussed in the literature [8,18]. The purpose of previous conducted studies has been to identify potential risk factors in order to reduce unnecessary investigations with US scans and MAG3 scans.…”

Section: Discussionmentioning

confidence: 99%

Resolution of hydronephrosis after pyeloplasty in children

Värelä

Omling

Börjesson

et al. 2021

Journal of Pediatric Urology

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Background There is still a lack of knowledge regarding the natural course of resolution of hydronephrosis after pyeloplasty, and no consensus exists on how resolution of hydronephrosis is defined or when resolution is expected to occur. Objective To determine when resolution of hydronephrosis occurs following pyeloplasty, by type of obstruction and by surgical approach. Methods This retrospective study included 125 children age <15 years treated with pyeloplasty and followed for two years with repeated ultrasound and MAG3 scan. Children with single kidneys, bilateral disease, and without hydronephrosis were excluded. Children with reinterventions were excluded in the evaluation of hydronephrosis but not in terms of success rate. Outcomes time to resolution of hydronephrosis (Anterior-Posterior diameter (APD) <10 mm or >50% reduction of APD) and 2-year success rate. Exposure was surgical approach and type of obstruction (intrinsic/extrinsic). Survival analysis was performed, adjusting for age, gender, year, laterality, preoperative renal function on MAG3, calyces dilatation and APD in the multivariable analysis. Results At 12 months and 24 months follow-up, 90% and 93% had reached resolution, respectively. All children with persistent dilatation had improved drainage and stable

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Imaging in children with unilateral ureteropelvic junction obstruction: time to reduce investigations?

Cited by 7 publications

References 19 publications

Long Term Follow-Up Of Patients With Nonrefluxing Hydronephrosis

Long Term Follow-Up Of Patients With Nonrefluxing Hydronephrosis

Laparoscopic management of pelvi-ureteric junction obstruction caused by aberrant renal vessels in an adult

Resolution of hydronephrosis after pyeloplasty in children

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