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Abstract

There have been many reports concerning pediatric uretero-pelvic junction obstruction (UPJO). However, most of them focused on the technical aspects of operation such as the diversion method, laparoscopic pyeloplasty or robotic pyeloplasty. The natural course of UPJO or the prediction of renal outcome in individual patient has been left vague. Although decrease in differential renal function (DRF) on renal scintigraphy and the aggravation of hydronephrosis on ultrasonography have been widely accepted as indications for pyeloplasty, these indications have a fundamental limitation. Only after we encounter disease progression can we perform surgery to prevent further progression with such indication. If we could know the degree of renal injury just before it happens or predict renal function deterioration correctly, we could perform surgery before damage in some patients and also prevent unnecessary operation in other patients. Editorial CommentUrologyVol. 81Issue 4PreviewThis article attempts to address one of the most challenging problems facing pediatric urology—how to evaluate, when ureteropelvic junction obstruction seems to be present, whether surgical intervention will at least stabilize renal function, may allow improvement in ipsilateral renal function, and, most difficult of all, how to predict the potential for renal deterioration if surgery is not done. For the most part, the available data, as incomplete as it may be, has been generated from cases of unilateral obstruction, in which the contralateral normal kidney can be used as an intrinsic control. Full-Text PDF