Long-term Outcomes of Patients with Giant Hydronephrosis After Pyeloplasty

Abstract

Objective: The study aims to assess the long-term outcomes of pyeloplasty performed for ureteropelvic junction obstruction (UPJO) with giant hydronephrosis (GH). Method: Data of 94 patients with ipsilateral UPJO patients who underwent pyeloplasty were analyzed. Patients’ demographic characteristics, pre-, and postoperative anteroposterior diameters (APDs) of their kidneys, parenchymal thickness (PT) ratio (PT of ipsilateral/contralateral kidneys) of kidneys, differential renal function (DRF) and surgical outcomes were compared between the GH (group of patients with AP diameter of at least 50 mm as measured on two ultrasonographys with thinner PT than ½ of the contralateral kidney) and the non-GH groups. Results: Six female, and 18 male children were included in the GH (mean APD: 60.46±9.25 mm), and the remaining 21 female, and 49 male patients in the non-GH group were used as controls. Preoperative PT ratios and DRFs were found to be impaired in the GH group compared to the non-GH group (p<0,05). No significant differences were found between the groups in terms of age, gender, laterality of pyeloplasty, operative success. APD and PT ratios of GH and non-GH groups of patients. APD and PT ratios were found to improve significantly after pyeloplasty (p<0.05). GH patients who underwent pyeloplasty before 1 year of age experienced significant improvement in their DRFs and PT ratios, while these parameters did not improve in older children who underwent pyeloplasty. Conclusion: Long-term outcomes of pyeloplasty are satisfactory in pediatric UPJO patients with GH, and their DRFs were stable even in late renograms. Early relief of the obstruction improves PT and renal functions in GH patients younger than 1 year of age.

Keywords

• differential renal function
• poorly functioning kidney
• pyeloplasty
• ureteropelvic junction obstruction
• renal parenchymal thickness