‘Pelvic Reduction During Pyeloplasty for Antenatal Hydronephrosis: Does It Affect The Outcome in Us and Nuclear Scan Postoperatively?’: A Prospective Randomized Study

Abstract

Purpose Comparing ultrasound (US) scan and nuclear renography findings in patients who underwent pyeloplasty with and without pelvic reduction in a randomized prospective study. Material and Methods 42 patients, all prenatally diagnosed with unilateral hydronephrosis, were included. Hydronephrosis was confirmed postnatally. 20 were randomly selected to undergo pyeloplasty with pelvic reduction and 22 underwent pelvis sparing pyeloplasty. Patients were evaluated with MAG-3 scans on 6th and US scans on 1st, 3rd and 6th months postoperatively. Mean follow up was 37±5, 6 weeks. Statistical analyses were performed using chi-square test and significance was set as p Results The AP pelvic diameter decreased significantly in the pelvic reduction group compared to pelvis sparing group in the first and third month US scans. However the difference was not significant on the 6th month. The improvements on the US findings for the pelvis sparing group catch up the pelvic reduction group later in postoperative period. Pelvic reduction significantly improved the renal wash out time (T ½) in MAG 3 renography when compared to pyeloplasty group without reduction at postoperative 6th month. Differential renal function (DRF) was found to be not affected from pelvic reduction. Conclusions Resolution of AP diameter in US scan is more prominent in the pelvic reduction group at earlier stages of the postoperative period. Although T ½ decreases more prominently at the pelvic reduction group, the employability of this is still indecisive. This feature can reveal possible surgical failures earlier and strengthen the values of US and renography postoperatively.