Functional outcome after neonatal pyeloplasty in antenatally diagnosed uretero-pelvic junction obstruction
Abstract Background With routine antenatal ultrasonography, fetal hydronephrosis is commonly diagnosed. This leads to early detection of postnatal uretero-pelvic junction obstruction which may require surgical intervention. But, there is no clear consensus in the benefits of operating these patients...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2021-01-01
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| Series: | African Journal of Urology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12301-021-00121-5 |
| _version_ | 1818665090558197760 |
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| author | Pradnya Suhas Bendre Parag Janardhan Karkera Monita Nanjappa |
| author_facet | Pradnya Suhas Bendre Parag Janardhan Karkera Monita Nanjappa |
| author_sort | Pradnya Suhas Bendre |
| collection | DOAJ |
| description | Abstract Background With routine antenatal ultrasonography, fetal hydronephrosis is commonly diagnosed. This leads to early detection of postnatal uretero-pelvic junction obstruction which may require surgical intervention. But, there is no clear consensus in the benefits of operating these patients in the neonatal age. Methods Aim—To study the functional outcome after pyeloplasty in neonates with antenatally diagnosed unilateral uretero-pelvic junction obstruction (UPJO). Records of all neonates (N = 48) who presented between 2016 and 2018 with prenatal diagnosis of unilateral UPJO and underwent a Anderson-Hyne’s Pyeloplasty were retrospectively analyzed. Indications for surgery were SFU grade 3 or 4, a split renal function (SRF) < 40% on a diuretic renal scan and antero-posterior renal pelvic diameter (APD) > 2.5 cm with parenchymal thinning. Parenchymal thickness (PT) and APD measured by ultrasonography, and SRF measured by 99 m Tc-EC renal scan were compared before and after surgery. Results Our study comprised of 48 patients with 79.2% males (n = 38). UPJO affected the left side more (n = 30, 62.5%). The mean age at pyeloplasty was 28 days (range 26–30). The outcome was considered successful in 46 (95.84%) patients. The APD decreased from a mean of 3.5 cm APD preoperatively to 1.38 cm 1 year later which was statistically significant (p < 0.001). The PT increased from 3.95 to 7.1 mm 1 year postoperatively which was significant (p < 0.001). The drainage pattern and SRF improved in 46 (95.84%) patients. The SRF improved from a mean of 35.48–44.7% 1 year postoperatively which was significant (p < 0.001). Conclusion Pyeloplasty done in the neonatal age for prenatally diagnosed UPJO, having SFU grade 3–4 UPJO, leads to significant improvement of SRF and PT with minimal complications. Neonatal Pyeloplasty for significant UPJO is a safe procedure which provides the kidney maximum opportunity to improve function. |
| first_indexed | 2024-12-17T05:43:06Z |
| format | Article |
| id | doaj.art-ad8ab17fd4e14c6d8de54565d3babbe9 |
| institution | Directory Open Access Journal |
| issn | 1110-5704 1961-9987 |
| language | English |
| last_indexed | 2024-12-17T05:43:06Z |
| publishDate | 2021-01-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | African Journal of Urology |
| spelling | doaj.art-ad8ab17fd4e14c6d8de54565d3babbe92022-12-21T22:01:23ZengSpringerOpenAfrican Journal of Urology1110-57041961-99872021-01-012711510.1186/s12301-021-00121-5Functional outcome after neonatal pyeloplasty in antenatally diagnosed uretero-pelvic junction obstructionPradnya Suhas Bendre0Parag Janardhan Karkera1Monita Nanjappa2Division of Pediatric Urology, Bai Jerbai Wadia Hospital for ChildrenDivision of Pediatric Urology, Bai Jerbai Wadia Hospital for ChildrenDivision of Pediatric Urology, Bai Jerbai Wadia Hospital for ChildrenAbstract Background With routine antenatal ultrasonography, fetal hydronephrosis is commonly diagnosed. This leads to early detection of postnatal uretero-pelvic junction obstruction which may require surgical intervention. But, there is no clear consensus in the benefits of operating these patients in the neonatal age. Methods Aim—To study the functional outcome after pyeloplasty in neonates with antenatally diagnosed unilateral uretero-pelvic junction obstruction (UPJO). Records of all neonates (N = 48) who presented between 2016 and 2018 with prenatal diagnosis of unilateral UPJO and underwent a Anderson-Hyne’s Pyeloplasty were retrospectively analyzed. Indications for surgery were SFU grade 3 or 4, a split renal function (SRF) < 40% on a diuretic renal scan and antero-posterior renal pelvic diameter (APD) > 2.5 cm with parenchymal thinning. Parenchymal thickness (PT) and APD measured by ultrasonography, and SRF measured by 99 m Tc-EC renal scan were compared before and after surgery. Results Our study comprised of 48 patients with 79.2% males (n = 38). UPJO affected the left side more (n = 30, 62.5%). The mean age at pyeloplasty was 28 days (range 26–30). The outcome was considered successful in 46 (95.84%) patients. The APD decreased from a mean of 3.5 cm APD preoperatively to 1.38 cm 1 year later which was statistically significant (p < 0.001). The PT increased from 3.95 to 7.1 mm 1 year postoperatively which was significant (p < 0.001). The drainage pattern and SRF improved in 46 (95.84%) patients. The SRF improved from a mean of 35.48–44.7% 1 year postoperatively which was significant (p < 0.001). Conclusion Pyeloplasty done in the neonatal age for prenatally diagnosed UPJO, having SFU grade 3–4 UPJO, leads to significant improvement of SRF and PT with minimal complications. Neonatal Pyeloplasty for significant UPJO is a safe procedure which provides the kidney maximum opportunity to improve function.https://doi.org/10.1186/s12301-021-00121-5NeonatalPyeloplastyUretero-pelvic junction obstruction |
| spellingShingle | Pradnya Suhas Bendre Parag Janardhan Karkera Monita Nanjappa Functional outcome after neonatal pyeloplasty in antenatally diagnosed uretero-pelvic junction obstruction African Journal of Urology Neonatal Pyeloplasty Uretero-pelvic junction obstruction |
| title | Functional outcome after neonatal pyeloplasty in antenatally diagnosed uretero-pelvic junction obstruction |
| title_full | Functional outcome after neonatal pyeloplasty in antenatally diagnosed uretero-pelvic junction obstruction |
| title_fullStr | Functional outcome after neonatal pyeloplasty in antenatally diagnosed uretero-pelvic junction obstruction |
| title_full_unstemmed | Functional outcome after neonatal pyeloplasty in antenatally diagnosed uretero-pelvic junction obstruction |
| title_short | Functional outcome after neonatal pyeloplasty in antenatally diagnosed uretero-pelvic junction obstruction |
| title_sort | functional outcome after neonatal pyeloplasty in antenatally diagnosed uretero pelvic junction obstruction |
| topic | Neonatal Pyeloplasty Uretero-pelvic junction obstruction |
| url | https://doi.org/10.1186/s12301-021-00121-5 |
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