Our experience of operated pediatric ureteropelvic junction obstruction patients

Abstract

Aims: Ureteropelvic junction obstruction (UPJO) may originate from extrinsic or intrinsic causes in children. The aim of this study is to present preoperative and postoperative data of our patients operated for UPJO. Methods: A total of 64 patients who underwent open pyeloplasty were investigated retrospectively. They were evaluated in terms of demographically, clinics, hydronephrosis, differential renal functions (DRFs), half-time tracer clearance (½TC), and histopathologic results. Patients’ numerical results were stated as mean ± standard deviation (SD). Results: Male gender was more prevalent ( n = 47, 73.4%) and mean age at surgery was 46.87 months. UPJO was located at the left side in 56.3% ( n = 36), and at the right side in 39.1% ( n = 25) of patients. It was bilateral in 4.7% ( n = 3). Hydronephrosis was found antenatally in 68.8% ( n = 44) of patients. The mean preoperative DRF was 49.7% (21–78%) and mean postoperative DRF was 49.2% (20–56%). Mean renal scintigraphic t1/2 was >20 min for all patients. The mean AP diameter was 21.58 mm (10–62 mm). Muscular hypertrophy was the most common pathological finding, mean length of excised segment was 10.26 mm (3–40 mm). Crossing vessel (CV) was detected in 17.18% ( n = 11). The CV was statistically associated with increased age of operation, left side, and female gender. Statistically significant hydronephrosis was found in non-CV patients. Re-operation was required in seven patients (7.8%). Conclusions: Intrinsic pathologies are more seen in the etiology of UPJO patients with antenatal diagnosis and this group needs operation at an earlier age. However, CV is found more commonly in patients who are diagnosed and operated at older ages.

Factors Influencing Postoperative Outcomes in Children with Ureteropelvic Junction Obstruction: A Logistic Regression Analysis

“…Age at surgery was identified as a significant prognostic factor for postoperative outcomes in this study, which is consistent with previous research demonstrating that a younger age at the time of surgery is associated with more favorable outcomes [7,10]. Despite the relatively limited regenerative potential of the kidneys, they do exhibit certain reparative capabilities following partial tissue injury [14].…”

“…Ultrasound reveals kidney morphology, reflecting renal function improvements and predicting long-term outcomes, particularly through morphological recovery such as cortical restoration [7,8]. Previous research examined factors influencing UPJO prognosis, such as age, hydronephrosis degree, diagnosis time, and infections [4,9,10]. Typically, these studies compared postoperative renal function in different groups, evaluating single factors without accounting for interactions or quantifying associations influencing UPJO surgical outcomes.…”

A Comparative Analysis of Robot-Assisted Laparoscopic Pyeloplasty in Pediatric and Adult Patients: Does Age Matter?

“…Crossing vessels account for 20–40% of UPJO in all age groups [ 29 , 30 ]. In this study, it accounted for 27.1% of pediatric UPJO and 43.5% of adult UPJO.…”