In children with an antenatal diagnosis of pelvi-ureteric junction (PUJ) obstruction, delayed pyeloplasty effectively restores initial renal function.
Authors from Our Lady’s Hospital for Sick Children, Dublin, Ireland and Ben-Gurion University, Jerusalem, (… צ”ל באר שבע)Israel, retrospectively assessed 44 children, aged on average 13.3 months, suffering from pelvi-ureteric junction obstruction.
Children were initially managed with observation alone and underwent pyeloplasty once renal function deteriorated. The researchers excluded children with bilateral disease, vesico-ureteric reflux or a single kidney. Initial mean renal function was 39.7 percent, ranging from 30.4 to 45.0 percent. Deteriorating renal function of at least 5 percent on renal scintigraphy was the main indication for pyeloplasty. Renal function declined by an average 8.2 percent before surgery. Thirty-five children had severe renal pelvic dilatation (more than 3 cm). The researchers followed the children for a mean 5.1 years.
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