Obstrucción congénita de la unión ureteropiélica. Estudio de casos en un centro de segundo nivel

Abstract

Objective: To evaluate the incidence, clinical characteristics, diagnosis, and treatment of congenital ureteropelvic junction obstruction in pediatric patients (CUPBO) at the Hospital Infantil de Morelia. Material and methods: This was a retrospective, observational, descriptive, and cross-sectional study of pediatric patients diagnosed with CUPBO and treated in the urology service of a second-level care medical center from January 2018 to December 2021. Results: We reviewed 53 patients with prenatal hydronephrosis who underwent postnatal follow-up, of whom only 6 patients diagnosed with congenital ureteropelvic junction obstruction (CUPBO) were identified prenatally. Seven patients were diagnosed with hydronephrosis postnatally and subsequently diagnosed with CUPBO, resulting in a total sample of 13 diagnosed patients. The incidence of CUPBO was 3.4 patients per 100 first visits to the Pediatric Urology Service. Of the cases, 92.31% were male, and the most frequent clinical manifestations were skin infections and localized pain. Surgery was performed in all cases, with Anderson-Hynes pyeloplasty being the most frequent procedure. Complications included urinary tract infections, wound infections, and fistula, but most patients had satisfactory results with a reduction of hydronephrosis after surgery. Findings or conclusions: Our study found a low rate of early detection of CUPBO in patients with prenatal hydronephrosis follow-up. We recommend an intentional search for urologic alterations in structural ultrasound scans of prenatal control. We emphasize the importance of an accurate diagnosis and timely treatment of CUPBO to prevent renal complications.