Pelvi-ureteric junction obstruction and renal function after pyeloplasty: a retrospective study in 29 children.

AIM

Actually, unilateral obstruction is not indicated for surgery, especially if renal function is unaffected. This retrospective study focused on the renal function after pyeloplasty for unilateral obstruction in children.

METHODS

Twenty-nine children were retrospectively reviewed. To compare the ultrasound readings in patients with different ages, the comparative-length-index (index) of each renal unit (RU) was calculated. MAG3 dynamic scintigraphy was applied to diagnose any obstructions.

RESULTS

Children with left obstruction were younger than children with right obstruction, when surgery was performed. Scintigraphic scan of right RUs with obstruction operated later was a lower at diagnosis than jet of the normal contralateral. Normal scintigraphic scan at diagnosis of left RUs with obstruction operated early revealed that RU was slightly reduced after the operation. At both diagnosis and follow-up the index between obstructed RUs and normal contralateral was comparable, even if it was significantly higher in left obstructed RUs. At follow-up, however, the scintigraphic scan revealed that RUs were more reduced in patients who were treated late.

CONCLUSION

Early pyeloplasty partially safeguard kidney function in children with unilateral obstruction, whose renal function was normal at birth. The reduced kidney function observed before surgery was not proportionally improved after surgery with respect to the contralateral that was not affected.