MP17-07 IMPACT OF DELAY IN SURGICAL INTERVENTION ON FUNCTIONAL OUTCOME IN CHILDREN WITH UNILATERAL URETERO-PELVIC JUNCTION OBSTRUCTION

Abstract

You have accessJournal of UrologyCME1 May 2022MP17-07 IMPACT OF DELAY IN SURGICAL INTERVENTION ON FUNCTIONAL OUTCOME IN CHILDREN WITH UNILATERAL URETERO-PELVIC JUNCTION OBSTRUCTION Mohamed Soltan, Ahmed Abdelhalim, Ahmed Elkashef, Mohamed Edwan, Ahmed Atwa, Mohamed Abou-El_Ghar, Tamer Helmy, Ashraf Tarek, Mohamed Dawaba, and Ahmed Shokier Mohamed SoltanMohamed Soltan More articles by this author , Ahmed AbdelhalimAhmed Abdelhalim More articles by this author , Ahmed ElkashefAhmed Elkashef More articles by this author , Mohamed EdwanMohamed Edwan More articles by this author , Ahmed AtwaAhmed Atwa More articles by this author , Mohamed Abou-El_GharMohamed Abou-El_Ghar More articles by this author , Tamer HelmyTamer Helmy More articles by this author , Ashraf TarekAshraf Tarek More articles by this author , Mohamed DawabaMohamed Dawaba More articles by this author , and Ahmed ShokierAhmed Shokier More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002550.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Uretero-pelvic junction obstruction (UPJO) is the commonest cause of obstructive uropathy in children. Timing of surgical intervention is debatable, meanwhile the effect of delay surgical intervention is not well understood. The objective of the study is to identify surgery delay effect on renal function in cases of UPJO and factors affecting it. METHODS: Data base of patients who underwent pyeloplasty for unilateral UPJO in a tertiary center from January 2016 to October 2020 was reviewed. Patients who had a delay in pyeloplasty for more than 3 months from time of diagnosis were identified. Patients for whom 3 renograms were performed at the time of surgical decision, immediately before surgery and within 1 year postoperative were included in the study. Deterioration was defined as 5 % or more decline in the split renal function SRF between 2 consecutive renograms.Patients were then categorized into 2 groups: preserved renal function (group 1) and deteriorated renal function (group 2) based on the difference in preoperative renograms. Both groups were compared regarding pre and postoperative Antero-posterior diameter (APD), hydronephrosis grading, percent of change of hydronephrosis, change in SRF, and delay duration in months. RESULTS: A total 46 patients were included in the analysis: 30 cases had preserved renal function while 16 had significant deterioration of SRF. Group 2 showed higher precent increase of APD and more delay in surgical intervention (table) on univariate analysis (P value 0.016 and 0.001 respectively). On multivariate analysis these factors showed significant difference between groups. Other factors did not show significant difference between the groups. No significant difference was found in postoperative change of SRF. None of the patients who had surgery within 6 months showed functional deterioration. CONCLUSIONS: Delaying of surgical intervention for less than 6 months doesn`t lead to significant functional deterioration. Worsening hydronephrosis precedes functional deterioration. Source of Funding: No © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e286 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mohamed Soltan More articles by this author Ahmed Abdelhalim More articles by this author Ahmed Elkashef More articles by this author Mohamed Edwan More articles by this author Ahmed Atwa More articles by this author Mohamed Abou-El_Ghar More articles by this author Tamer Helmy More articles by this author Ashraf Tarek More articles by this author Mohamed Dawaba More articles by this author Ahmed Shokier More articles by this author Expand All Advertisement PDF DownloadLoading ...