Results of Pyeloplasty in patients with Ureteropelvic Junction Obstruction in Pediatric Surgery Center in Bandar Abbas

Introduction: Ureteropelvic junction obstruction (UPJO) is associated with inadequateurine drainage from renal pelvis into ureter. UPJO results from incomplete recanalizationof proximal ureter during fetal period which finally leads to hydrostatic distention of renalpelvis and calyces. Diagnosis is based on clinical symptoms, ultrasound, and diureticisotopic renogram. Various surgical methods are used for treatment includingdismembered pyeloplasty which is associated with better outcomes.Methods: Patients with UPJO who were undergone pyeloplasty (in an interval of 2.5years) were followed and their pre- and postoperative ultrasounds and diuretic isotopicrenograms were compared in terms of renal pelvis AP diameter in ultrasound and renalflow rate after injection of diuretics in renal scan.Results: Of 22 patients included in this study, postoperative renal pelvis AP diameter andrenal flow rate were reduced in one patient, who then underwent reoperation with adiagnosis of recurrence. Despite normal postoperative renal flow scan, renal pelvis APdiameter in ultrasound had no significant change after surgery than before surgery in 4patients (mean change 0.5 mm). Pelvis AP diameter was slightly increased in 2 patients(mean change 1.8 mm). Pelvis AP diameter was increased in the remaining 15 patientsafter surgery (mean 11.3 mm). Renal flow was increased following administration ofdiuretics in all patients (P<0.001).Conclusion: The present study showed that ultrasound based on renal pelvis APdiameter cannot definitely predict outcomes of patients with UPJO and renal scan is areliable tool for evaluation of patients clinical and renal function improvement.

Keywords:

Urinary Tract , Ureteropelvic Junction Obstruction , Radioisotoperenography