Objective: To describe and analyze the clinical manifestation and pre-DRF of UPJO children with polyps and explore the possible influencing factors of supranormal pre-DRF.
Patients And Methods: All patients undergoing primary Anderson-Hynes pyeloplasty for UPJO due to polyp were retrospectively reviewed. Patients' characteristics, parameters of ultrasound and dynamic renograms (DR) were recorded in elaborate. Pre-DRF in groups of different age, weight, gender, pain, grade of hydronephrosis, anterio-posterior pelvic diameter (APD), length of kidney and postoperative ultrasonic parameters were compared.
Results: A total of 18 UPJO children with polyps were included. Five (27.78%) patients had SFU III grade of hydronephrosis. Seven (38.89%) patients were supranormal pre-DRF. All patients had pre-DRF > 40%. Drainage curve was delayed excretion in 12 (66.67%) patients and T < 20 min was in 4 (22.22%) patients. Among the 16 patients who underwent preoperative IVP examination, 15 (93.75%) patients had concentration of intrarenal pelvis contrast agent within 10 min. No significant difference in post-APD reduction rate and post-PT increased was found between supranormal pre-DRF and non-supranormal pre-DRF groups. The supranormal pre-DRF was more likely to occur in young and low-weight children.
Conclusion: The preoperative renal function of UPJO patients with polyps was well preserved, and 38.89% of them had supranormal pre-DRF. Patients with supranormal pre-DRF can be managed with the same strategies as those with normal renal function.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1007/s11255-023-03827-3 | DOI Listing |
Int Urol Nephrol
January 2025
Pediatric Urology and Regenerative Medicine Research Center, Children's Medical Center, Tehran University of Medical Sciences, No. 62, Dr. Gharib's Street, Keshavarz Boulevard, Tehran, 1419433151, Iran.
Background: The clinical significance and optimal management of supranormal differential renal function (DRF ≥ 55%) in pediatric ureteropelvic junction obstruction (UPJO) remain debated. This study investigated supranormal DRF clinical characteristics and evaluated surgical versus conservative management outcomes to guide decision-making.
Methods: We retrospectively reviewed 76 children with unilateral UPJO who underwent standardized DMSA and DTPA scans at a single center (2020-2022).
Sci Rep
January 2025
Department of Urology, Capital Institute of Pediatrics, Beijing, China.
Ureteropelvic junction obstruction (UPJO) is a common pediatric condition often treated with pyeloplasty. Despite the surgical intervention, postoperative urinary tract infections (UTIs) occur in over 30% of cases within six months, adversely affecting recovery and increasing both clinical and economic burdens. Current prediction methods for postoperative UTIs rely on empirical judgment and limited clinical parameters, underscoring the need for a robust, multifactorial predictive model.
View Article and Find Full Text PDFJ Robot Surg
January 2025
Department of Pediatric Anesthesia and Intensive Care, Necker-Enfants Malades University Hospital, AP-HP Centre, Université Paris Cité, 149, Rue de Sèvres 75015, Paris, France.
Retroperitoneal robotic-assisted laparoscopic pyeloplasty (R-RALP) is the commonest urologic procedure performed in children, entailing retroperitoneal CO2 insufflation and lateral decubitus, whose effects on cardiopulmonary variables are poorly known. We, therefore, studied hemodynamic and respiratory changes due to CO2 insufflation and lateral decubitus in children undergoing R-RALP and their effects on regional tissue oxygenation. Between 1/2021 and 7/2024, children affected by ureteropelvic joint obstruction (UPJO) underwent a pyeloplasty by R-RALP at Necker Enfants Malades Hospital (Paris, France), using a standardized surgical technique and a lung-protecting anesthetic protocol aimed to prevent hypercarbia.
View Article and Find Full Text PDFAsian J Endosc Surg
December 2024
Department of Pediatric General & Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan.
A case of redo pyeloplasty using robot-assisted retroperitoneoscopic pyeloplasty (RARP) for failed primary laparoscopic pyeloplasty (LP) for ureteropelvic junction obstruction (UPJO) is reported. A 12-year-old boy had LP elsewhere. He was referred for management of persistent left hydronephrosis, but was managed conservatively due to minimal symptoms and stable radioisotopic renography.
View Article and Find Full Text PDFJ Pediatr Urol
November 2024
Department of Urology, Ankara City Hospital, Ankara, Türkiye. Electronic address:
Background: The study aimed at evaluating the role of thiol-disulphide balance parameters [native thiol (SH), total thiol (SH + SS), disulphide (SS), disulphide/native thiol ratio (% SS/SH), disulphide/total thiol ratio (% SS/Total Thiol) and native thiol/total thiol ratio (%SH/Total Thiol)], which are important oxidative stress markers in the congenital ureteropelvic junction (UPJ) stenosis, in the diagnosis of the disease, and its role in determining the need for surgery and follow-up.
Materials And Methods: This prospective study included 30 children diagnosed with congenital intrinsic ureteropelvic junction obstruction (UPJO) and a control group of 30 healthy children admitted to the pediatric clinic between January 2016 and February 2017. The children with UPJO underwent laparoscopic dismembered pyeloplasty.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!