MP71-04 ANY INTERVENTION AFTER PYELOPLASTY: THE INCIDENCE, ETIOLOGY AND OUTCOMES

Abstract

You have accessJournal of UrologyPediatrics: Upper Urinary Tract Disorders and Fetal Urology (MP71)1 Apr 2020MP71-04 ANY INTERVENTION AFTER PYELOPLASTY: THE INCIDENCE, ETIOLOGY AND OUTCOMES Aznive H. Aghababian*, Sameer Mittal, Lauren Dinardo, Dana A. Weiss, Christopher J. Long, Aseem R. Shukla, and Arun K. Srinivasan Aznive H. Aghababian*Aznive H. Aghababian* More articles by this author , Sameer MittalSameer Mittal More articles by this author , Lauren DinardoLauren Dinardo More articles by this author , Dana A. WeissDana A. Weiss More articles by this author , Christopher J. LongChristopher J. Long More articles by this author , Aseem R. ShuklaAseem R. Shukla More articles by this author , and Arun K. SrinivasanArun K. Srinivasan More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000951.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Pyeloplasty for ureteropelvic junction obstruction (UPJO) ultimately has a >95% success rate, but the incidence of additional procedures en route to recovery is not well known. We hypothesized that the incidence of additional procedures is low and differences in management techniques of recurrent UPJO can be characterized. METHODS: A retrospective review was performed on all patients undergoing an open or minimally invasive pyeloplasty from 2012-2019. Patients requiring a subsequent unplanned procedure after the initial reconstruction were identified. Further data was abstracted on patients presenting signs and symptoms of recurrent UPJO, and on the techniques used in their subsequent treatment. Comparative statistics were performed using non-parametric and binary/categorical tests as appropriate. RESULTS: From 2012 to 2019, 386 patients were identified and 9.6% (n=36) underwent a subsequent unplanned procedure during the follow-up period. Of those 36, interventions were performed for stone disease in 5 (13.8%), stent migration in 11 (30.6%) and signs and symptoms of recurrent UPJO in 20 (55.6%) [Figure 1]. Of the 20 patients with concerns for recurrent UPJO, 6 (30%) patients were managed with only-endoscopic techniques and 14 (70%) patients ultimately required redo pyeloplasty or ureterocalicostomy. Between these two groups, more endoscopic procedures were performed in those ultimately requiring a redo reconstruction (2.0 vs 3.3, p<0.074) and no patient with a crossing vessel as the etiology of their UPJO was successfully managed endoscopically only (p<0.042) [Table 1]. Additionally, no difference in the time to 1st intervention or the type of initial pyeloplasty performed was identified between the two groups. CONCLUSIONS: Reconstruction for a UPJO is associated with a near 10% risk of requiring an additional intervention despite the high overall success rate. Recurrent UPJO with a history of a crossing vessel should have early redo reconstruction. These additional procedures may be a modifiable driver of morbidity and cost associated with the treatment of UPJO. Source of Funding: Children's Surgical Associates © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1065-e1065 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Aznive H. Aghababian* More articles by this author Sameer Mittal More articles by this author Lauren Dinardo More articles by this author Dana A. Weiss More articles by this author Christopher J. Long More articles by this author Aseem R. Shukla More articles by this author Arun K. Srinivasan More articles by this author Expand All Advertisement PDF downloadLoading ...