Renal Function Before and After Pyeloplasty: Does It Improve?

Does delaying pyeloplasty affect renal function in children with a prenatal diagnosis of pelvi‐ureteric junction obstruction?

“…The postnatal treatment of children with prenatally diagnosed hydronephrosis remains controversial in terms of the optimal timing of surgery, the ability to define which kidney will benefit from surgical intervention and which children will have a deterioration in renal function under surveillance [3][4][5][6][7][8][9][10]. The recovery of kidney function after either surgery or conservative management is the main issue in the treatment of patients with PUJ obstruction [6][7][8][9]15,16].…”

“…The recovery of kidney function after either surgery or conservative management is the main issue in the treatment of patients with PUJ obstruction [6][7][8][9]15,16]. Recently there has been a trend away from aggressive surgery to a more conservative approach [14,15].…”

“…In contrast to the present study, others found no improvement in renal function after pyeloplasty. McAleer and Kaplan [8] noted that a third of patients with a prenatal diagnosis of PUJ obstruction and followed conservatively ultimately required pyeloplasty; the authors detected no recovery in renal function after surgery and suggested more aggressive treatment for patients with a prenatal diagnosis of PUJ obstruction. Cornford and Rickwood [16] reported no recovery of renal function among children initially followed expectantly and emphasized that loss of function could be avoided by early surgery.…”

“…Maternal ultrasonography detects fetal hydronephrosis, leading to the diagnosis of PUJ obstruction postnatally in 0.2-0.4% of cases [1][2][3][4][5]; PUJ obstruction requires surgery in 15-30% of affected children [6][7][8][9][10][11][12][13][14]. Controversy continues on the optimal timing of the surgical correction in these children with antenatally detected hydronephrosis [7,8,[14][15][16][17]. Children with an antenatal diagnosis of PUJ obstruction reportedly show a significant improvement in renal function after surgery compared with those who are diagnosed and operated much later because of their clinical symptoms [12].…”

The early and late period alterations on the contralateral renal parenchyma secondary to unilateral ureteropelvic junction obstruction: experimental study

“…Erken pyeloplastinin renal fonksiyonları korumada rolünün olmadığı da bildirilmiştir (22) . Buna karşın McAleer ve Kaplan (23) gecikmiş pyeloplastinin kalıcı renal hasara neden olacağını raporlamıştır. Benzer şekilde Chertin ve ark.…”