Pyeloplasty may reverse the effect of growth delay from ureteropelvic junction obstruction in infants.

Abstract

To determine if children with UPJO demonstrate a clinically significant change in somatic growth following pyeloplasty. We retrospectively evaluated the growth chart data of infants with SFU grade 3 or 4 congenital hydronephrosis at our institution from 2015 to 2022. Of those, 35 patients underwent pyeloplasty and 66 had no surgical intervention. Patients met criteria if they had SFU 3 or 4 hydronephrosis and MAG3 renal scan. If patients underwent surgery, height and weight percentiles were recorded from the pre-op and 6-16-month follow-up visits. In non-surgery patients, measurements were taken near the median age of surgery in the intervention group and 6-16months later. Interval changes in group height and weight percentiles are compared for significant changes. The surgery and non-surgery groups did not differ in terms of gender (71% vs 74% Male), starting age (296 vs 244days), starting weight (58th vs 52nd percentile), or time between measurements (255 vs 260days), though the surgery group had significantly less height in the pre-operative period (43rd vs 55th percentile, p = 0.050) and were more likely to have delayed drainage on renal scan (83% w/delay vs 35%). The surgery group showed a significant increase in height (18.9 percentiles; 95% CI 11-27) and weight (6.0 percentiles; 95% CI 0.50-12) after intervention. Patients with congenital hydronephrosis due to UPJO that underwent pyeloplasty showed a significant increase in weight and height at 6-16months postoperatively compared to those that were managed with close observation. This suggests UPJO might lead to growth delay in infants.