Comparative Study of the Success Rate of Pyeloplasty in Patients with Ureteropelvic Junction Obstruction in Three Age Groups: Less than 3 Months, 3 Months to 1 Year, and More than One Year Old

Abstract

Background and Objective: Ureteropelvic junction obstruction (UPJO) is one of the most common congenital urinary tract abnormalities, which if left untreated can lead to impaired renal function. There is controversy over when is the best time for surgery (early or delayed). Therefore, we decided to design a study based on our clinical experience to evaluate the success rate of pyeloplasty in different age groups. Materials and Methods: In this cross-sectional study, 110 patients who underwent pyeloplasty in Shahid Beheshti Hospital, Hamedan, Iran, from 2014 to 2019 were studied. A total of 26 patients were excluded from the study due to bilateral obstruction, or other concomitant urological disorders. We retrospectively reviewed the medical records of patients to collect demographic characteristics, clinical presentation, postoperative complications, anteroposterior pelvic diameter, parenchymal thickness, and the success rate of pyeloplasty. Results: Of 84 patients studied, 61 (72.6%) were male and 23 (27.4%) were female. Regarding the age of the patients, 22 (26.2%) individuals were less than 3 months old, 30 (35.7%) between 3 months to 1 year old, and 32 (38.1%) more than 1 year old. In total, surgery was successful in 72 (85.7%) patients. The success rates in the age groups of less than 3 months, 3 to 12 months, and more than 12 months were 90.9%, 86.7%, and 81.2%, respectively (P=0.598). It was found that APD decreased significantly after the surgery in all age groups (P=0.001), this change was significantly seen in the age group of less than 3 months (P=0.016). The most common complication was fever reported in 9.5% of the patients. Conclusion: The findings of the present study showed that early pyeloplasty surgery in infants and children with a diagnosis of high-grade UPJO could lead to improve morphological indices of the kidney and prevent complications.