569 CAN PYELOPLASTY BE DELAYED IN URETEROPELVIC JUNCTION OBSTRUCTION WITH SUPRANORMAL DIFFERENTIAL RENAL FUNCTION?

Abstract

You have accessJournal of UrologyPediatrics: Imaging/Infections & Vesicoureteral Reflux1 Apr 2011569 CAN PYELOPLASTY BE DELAYED IN URETEROPELVIC JUNCTION OBSTRUCTION WITH SUPRANORMAL DIFFERENTIAL RENAL FUNCTION? Myung Up Kim, Young Jae Im, Hyun Jin Jung, Yong Seung Lee, Chang Hee Hong, and Sang Won Han Myung Up KimMyung Up Kim Seoul, Korea, Republic of More articles by this author , Young Jae ImYoung Jae Im Seoul, Korea, Republic of More articles by this author , Hyun Jin JungHyun Jin Jung Seoul, Korea, Republic of More articles by this author , Yong Seung LeeYong Seung Lee Seoul, Korea, Republic of More articles by this author , Chang Hee HongChang Hee Hong Seoul, Korea, Republic of More articles by this author , and Sang Won HanSang Won Han Seoul, Korea, Republic of More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1379AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The management of ureteropelvic junction obstruction (UPJO) in patients with supranormal ipsilateral differential renal function (DRF) is obscure. We analyzed the change of ipsilateral DRF before and after pyeloplasty to understand the significance of supranormal ipsilateral DRF. METHODS We retrospectively reviewed the medical records of 206 patients who underwent pyeloplasty between January 2005 and June 2009. In 56 patients, ipsilateral DRF at initial diagnosis was more than 55%. We divided them into two groups-patients with more than 5% decreased in ipsilateral DRF before pyeloplasty as group A (23 patients) and all other patients as group B (33 patients). We analyzed ultrasonography and MAG3 scan before and after surgery along with other clinical parameters. RESULTS There was no difference in age, sex, laterality, grade of hydronephrosis between the two groups. Mean ipsilateral DRF was not significantly different (57.8% vs. 58.3%). Duration from diagnosis to surgery was 9.1 months and 3.5 months for group A and B, respectively (p=0.002). In group A, the mean duration from initial diagnosis to a more than 5% decrease in ipsilateral DRF was 7.5 months. Postoperatively mean 15.7 months , mean ipsilateral DRF was 42.4% in group A and 50.8 in group B (p=0.004). 10 patients (43.5%) in group A and 3 patients (9.1%) in group B eventually had ipsilateral DRF below 45%. CONCLUSIONS Supranormal ipsilateral DRF may be temporary. If it is decreased more than 5%, it could be the reason for irreversible renal damage even after pyeloplasty. We should carefully follow up patients with supranormal DRF in UPJO. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e229 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Myung Up Kim Seoul, Korea, Republic of More articles by this author Young Jae Im Seoul, Korea, Republic of More articles by this author Hyun Jin Jung Seoul, Korea, Republic of More articles by this author Yong Seung Lee Seoul, Korea, Republic of More articles by this author Chang Hee Hong Seoul, Korea, Republic of More articles by this author Sang Won Han Seoul, Korea, Republic of More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...