The role of ultrasound in the follow-up of postoperative changes after pyeloplasty

Abstract

Resolution of hydronephrosis after surgery is relatively slow, but renal parenchymal growth is rapid. Mild postoperative pelvic dilatation is frequent and does not indicate continued obstruction.

Pelvis/cortex ratio: An early marker of success following pyeloplasty in children

“…Amling et al [5] showed hydronephrosis to be the same or worse during early follow up, while Neste et al [6] noted that the majority of cases took more than 6 months to improve on USG. Kis et al [7] showed that resolution in hydronephrosis is slow but parenchymal growth is rapid following surgery. Onen [9] showed that neither the Society of Fetal Urology system nor APPD could act as the gold standard in determining the severity of hydronephrosis.…”

Hydronephrosis after retroperitoneal laparoscopic dismembered Anderson–Hynes pyeloplasty in adult patients with ureteropelvic junction obstruction: A longitudinal analysis

“…Amling [7] reported that only 38% of the kidneys improved during the first 6 months of follow–up, while 81% were improved 2 years postoperatively, and ultimate improvement to grade 0 or 1 was noted in only 19% of cases. Kis et al [13] reported that 102 babies who underwent pyeloplasty were investigated by US at 6 and 12 months postoperatively. One year after surgery, the renal pelvis was smaller in 76% of cases, and renal parenchyma was normal or had increased in 92% of cases.…”

Calyx to parenchyma ratio in pelvi‐ureteric junction obstruction

“…Kis et al [2] reported that the improvement in pelvic dilatation was slow in the first year after surgery while the increase in thickness of the renal parenchyma is relatively fast. However, monitoring the size of the renal pelvis after Anderson‐Hynes pyeloplasty is less meaningful, as the residual renal pelvic size reflects surgical technique, particularly if the pelvis is trimmed.…”

“…However, it is not yet well established which preoperative findings best correlate with the long‐term outcome. Neste et al [1] and Kis et al [2] suggested that the US findings may appear worse after surgery, but no systematic analysis has yet been published. An operation designed to improve drainage would be expected to decrease the degree of hydronephrosis.…”