The Value of Radiological Studies of the Ureter in Management of Ureteropelvic Junction Obstruction

Abstract

To evaluate the necessity to do voiding cystogram and retrograde pyelography in the preoperative evaluation of children undergoing pyeloplasty In the present study, the records of 64 children were reviewed who underwent 72 dismembered pyeloplasty for Ureteropelvic Junction (UPJ) Obstruction between January 1992 and June 2002. The preoperative clinical evaluation included urinalysis, renal function profile, renal and bladder Ultrasound, diuretic renal isotope scan studies, intravenous pyelogram, voiding cytourethrogram, and retrograde pyelogram. The patients were divided into 3 groups according to either they had retrograde pyelogram and voiding cytourethrogram or not. All patients had done ultrasonography and dilated upper ureter was found in 3 cases only. Voiding cytourethrogram had showed vesicoureteral reflux in 5 patients (9.6%) in Groups 1 and 2, one patient had a successful Ureteral reimplantation for bilateral vesicoureteral reflux. In Group 2, the retrograde pyelogram revealed abnormalities in 3 cases (8.1%) and there was no significant difference in the success rate of pyeloplasty among the three groups. Cystoscopy and retrograde pyelogram are unnecessary in preoperative evaluation prior to pyeloplasty.