Is Routine Postoperative Diuresis Renography Indicated in All Adult Patients After Pyeloplasty for Ureteropelvic Junction Obstruction?

Lam, Wayne; Fernando, A.; Issa, Rami; Heenan, Susan; Sandhu, Sarb; Roux, Pieter Le; Anderson, Christopher J.

doi:10.1016/j.urology.2014.09.033

Cited by 20 publications

(22 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Despite the strong position of RN in UPJO diagnosis, there are publications indicating that it may not be necessary to perform routine RN to assess drainage and assess renal function in patients who become pain-free after UPJO operative treatment. 8 Ultrasonography ranks first among the diagnostic procedures used to detect UPJO. However, ultrasonography does not provide information on the renal function of the hydronephrotic kidney.…”

Section: Diagnosismentioning

confidence: 99%

Hydronephrosis in the course of ureteropelvic junction obstruction - an underestimated problem?Current opinion on pathogenesis, diagnosis and treatment.

et al. 2017

View full text Add to dashboard Cite

Ureteropelvic junction obstruction (UPJO) causes a reduction in the urine flow from the renal pelvis into the ureter. Untreated UPJO may cause hydronephrosis, chronic infection or urolithiasis and will often result in progressive deterioration of renal function. Most cases of UPJO are congenital; however, the disease can be clinically silent until adulthood. Other causes, both intrinsic and extrinsic, are acquired and include urolithiasis, post-operative/inflammatory/ischemic stricture, fibroepithelial polyps, adhesions and malignancy. In the past, the most frequent symptom of UPJO in neonates and infants was a palpable flank mass. Nowadays, thanks to the widespread use of maternal and prenatal ultrasound examinations, asymptomatic hydronephrosis is diagnosed very early. In adults and older children symptoms may include intermittent abdominal or flank pain, nausea, vomiting and hematuria. In addition to high specificity and sensitivity in detecting UPJO, modern technologically advanced equipment such as ultrasound, magnetic resonance imaging and computed tomography provides a lot of information about the function of the affected kidney and the anatomy of the surrounding tissues. Treatment options for UPJO include a wide spectrum of approaches, from active surveillance or minimally invasive endourologic techniques to open, laparoscopic or robotic pyeloplasty. The main goal of therapy is to relieve symptoms and maintain or improve renal function, but it is difficult to define treatment success after UPJO therapy.

show abstract

Section: Diagnosismentioning

confidence: 99%

Hydronephrosis in the course of ureteropelvic junction obstruction - an underestimated problem?Current opinion on pathogenesis, diagnosis and treatment.

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Ein Vergleich des Outcomes verschiedener Operationstechniken wird hierdurch erschwert. Anerkannt ist das Konzept des klinischen sowie radiologischen/nuklearmedizinischen Erfolges, wobei klinisch eine vollständige Regredienz der Beschwerden und radiologisch/nuklearmedizinisch ein wiederhergestellter Harnabfluss den Erfolg ausmachen [1,12].…”

Section: Indikation Zur Pyeloplastikunclassified

Therapie der ureteropelvinen Stenose im Erwachsenenalter

et al. 2017

View full text Add to dashboard Cite

Ureteropelvic stenosis, also known as ureteropelvic junction obstruction, is an obstruction in the region of the pyeloureteral junction resulting in a urinary discharge disorder of the renal pelvis, which requires treatment.Since the first description of pyeloplasty by Trendelenburg in 1886 and the successful establishment of open pyeloplasty by Anderson and Hynes in 1949, the treatment strategies for ureteropelvic junction obstruction have developed considerably, especially in the last two decades. Although open pyeloplasty is still considered to be the gold standard, this concept is supplemented by modern minimally-invasive techniques today. These include laparoscopic pyeloplasty, laparoscopic single-site pyeloplasty, robot-assisted pyeloplasty, robot-assisted single-site pyeloplasty, and endopyelotomy. This article provides an overview of the different treatment strategies for ureteropelvic junction obstruction as well as the complication management of pyeloplasty in adult age.

show abstract

“…A necessidade da realização de uma cintilografia renal no seguimento pós-operatório em pacientes submetidos a pieloplastia foi recentemente questionada por Lam et al (191) . Em seu estudo envolvendo 90 pacientes submetidos a pieloplastia aberta, laparoscópica e laparoscópica assistida pelo robô, foi sugerido que caso o paciente não estivesse apresentando queixa de desconforto abdominal ou em flanco na primeira reavaliação 3 meses após o procedimento, a utilização de tal exame não seria necessária, demonstrando que mais de 98% dos pacientes assintomáticos demonstraram um renograma estável ou com melhora em um seguimento médio de 21 meses (191) .…”

Section: Intercorrências E Complicaçõesunclassified

“…Apesar do uso frequente da cintilografia renal na avaliação e seguimento dos pacientes com obstrução da JUP, os custos, a exposição à radiação ionizante associado a algumas dificuldades de interpretação na presença de hidronefrose significativa (136) podem ser fatores que favoreçam um menor uso deste exame e a aplicação de uma avaliação mais criteriosa para sua indicação (191) .…”

Section: Intercorrências E Complicaçõesunclassified

Avaliação do tratamento cirúrgico da obstrução da junção pielo-ureteral por meio de pieloplastia vídeo-laparoscópica robótica assistida

Júnior¹,

Fernandes²

View full text Add to dashboard Cite

Is Routine Postoperative Diuresis Renography Indicated in All Adult Patients After Pyeloplasty for Ureteropelvic Junction Obstruction?

Cited by 20 publications

References 13 publications

Hydronephrosis in the course of ureteropelvic junction obstruction - an underestimated problem?Current opinion on pathogenesis, diagnosis and treatment.

Hydronephrosis in the course of ureteropelvic junction obstruction - an underestimated problem?Current opinion on pathogenesis, diagnosis and treatment.

Therapie der ureteropelvinen Stenose im Erwachsenenalter

Avaliação do tratamento cirúrgico da obstrução da junção pielo-ureteral por meio de pieloplastia vídeo-laparoscópica robótica assistida

Contact Info

Product

Resources

About