You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Ureter (including Pyeloplasty) and Bladder Reconstruction (including fistula), Augmentation, Substitution, Diversion II (PD41)1 Apr 2020PD41-09 THE UTILITY OF RADIOLOGIC AND SYMPTOMATIC SURVEILLANCE AFTER PYELOPLASTY Peris Castaneda*, Henry Valora Tapia, J. Stuart Wolf, Paholo Barboglio-Romo, Bahaa Malaeb, John Stoffel, Yooni Yi, and Sapan Ambani Peris Castaneda*Peris Castaneda* More articles by this author , Henry Valora TapiaHenry Valora Tapia More articles by this author , J. Stuart WolfJ. Stuart Wolf More articles by this author , Paholo Barboglio-RomoPaholo Barboglio-Romo More articles by this author , Bahaa MalaebBahaa Malaeb More articles by this author , John StoffelJohn Stoffel More articles by this author , Yooni YiYooni Yi More articles by this author , and Sapan AmbaniSapan Ambani More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000921.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: A combination of symptom assessment and imaging is used to assess for obstruction after pyeloplasty (PY), however current evidence does not support whether these are useful tools to predict PY failure. We sought to evaluate failure after PY when stratified by initial radiologic study and symptoms after ureteral stent removal. METHODS: We performed a retrospective review of adult patients who underwent minimally-invasive PY from 1996 to 2019 at a single academic center. Patients lost to follow up were excluded. Post-procedure, following stent removal, patients were categorized as normal, equivocal, or obstructed based on their initial radiologic test and asymptomatic, mild, or severe based on symptoms. Primary outcome was procedural failure (PF) as defined as the need for a procedure to treat recurrent obstruction. Secondary outcome was radiologic failure. Groups were compared to assess for statistical significance (p<0.05). RESULTS: We identified 299 patients who met inclusion criteria. On initial post-operative imaging, 226 (76%) patients had no obstruction, 30 (10%) had equivocal findings, and 43 (14%) had obstruction (Table 1). Figure 1 demonstrates PF based on radiologic (A) and symptomatic (B) groups. PF occurred in 4% (normal), 13% (equivocal), and 49% (obstructed) of patients. The majority of equivocal (86%) and obstructed (67%) patients managed with surveillance developed improved imaging. PF developed in 0.6% of asymptomatic patients and 2.8% of minimally symptomatic patients with an initial normal radiologic study. Radiologic failure developed in 10 (4%) normal and 2 (7%) equivocal group patients (p=0.59). CONCLUSIONS: Recurrent obstruction after pyeloplasty varied based on the outcome of the initial radiologic study. These rates can be used to counsel patients and guide physicians’ choice of surveillance schedules. The risk of future failure is very low in asymptomatic patients with normal initial imaging. The utility of routine radiologic surveillance in these patients may be low. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e824-e825 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Peris Castaneda* More articles by this author Henry Valora Tapia More articles by this author J. Stuart Wolf More articles by this author Paholo Barboglio-Romo More articles by this author Bahaa Malaeb More articles by this author John Stoffel More articles by this author Yooni Yi More articles by this author Sapan Ambani More articles by this author Expand All Advertisement PDF downloadLoading ...