[43] Post-pyeloplasty follow-up plan, less invasive plan

Objective: To describe a well-structured postoperative pyeloplasty protocol for follow-up, with less cost and minimal possibility of nephron function loss, as pelvi-ureteric junction obstruction (PUJO) is the most common uropathology found in of patients with antenatal hydronephrosis (HN; 30%), with...

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Autor principal:	Abdulhakim Alotay
Formato:	article
Lenguaje:	EN
Publicado:	Taylor & Francis Group 2018
Materias:	Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/bd6e34908b494004a3d972aed4b97e88
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spelling	oai:doaj.org-article:bd6e34908b494004a3d972aed4b97e882021-12-02T10:36:47Z[43] Post-pyeloplasty follow-up plan, less invasive plan2090-598X10.1016/j.aju.2018.10.090https://doaj.org/article/bd6e34908b494004a3d972aed4b97e882018-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2090598X18301840https://doaj.org/toc/2090-598XObjective: To describe a well-structured postoperative pyeloplasty protocol for follow-up, with less cost and minimal possibility of nephron function loss, as pelvi-ureteric junction obstruction (PUJO) is the most common uropathology found in of patients with antenatal hydronephrosis (HN; 30%), with no agreement regarding the ’gold standard’ investigation to use after pyeloplasty for PUJO. Methods: We retrospectively evaluated 130 paediatric patients with congenital PUJO in the period 2009–2013. Patients with bilateral PUJO or unilateral PUJO in a solitary kidney, associated with a dilated ureter or reflux, and patients with missed follow-up were excluded. We included only those with unilateral PUJO. Open dismembered pyeloplasty with stenting was the technique used in all cases. All patients were investigated postoperatively by multiple ultrasonographies and at least one diuretic renography. Results: In all, 95 patients with a mean (range) age of 48 (3–180) months were included. After a mean (range) follow-up period of 4 (2–6) years, we assessed outcomes. Overall, 70 patients (73.7%) showed improved HN, 20 (21%) had stable HN, and five (5.3%) had deteriorated and needed re-intervention. Of the improved group, 39 patients (55.7%) improved within the first 6 months and 59 (84.3%) by the end of the first postoperative year, whilst the remaining patients improved in a time range of 2–6 years. None of the improved or stable group had an obstructive washout curve. Conclusions: As most of the improvement occurs within the first 12 months after pyeloplasty, ultrasonography can be the single modality used for follow-up for the first year post-pyeloplasty for patients with improved HN and those with non-obstructive curves. Only for patients with unimproved HN by the end of the first year post-pyeloplasty, should further investigations be implemented to exclude obstruction.Abdulhakim AlotayTaylor & Francis GrouparticleDiseases of the genitourinary system. UrologyRC870-923ENArab Journal of Urology, Vol 16, Iss , Pp S21- (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the genitourinary system. Urology RC870-923
spellingShingle	Diseases of the genitourinary system. Urology RC870-923 Abdulhakim Alotay [43] Post-pyeloplasty follow-up plan, less invasive plan
description	Objective: To describe a well-structured postoperative pyeloplasty protocol for follow-up, with less cost and minimal possibility of nephron function loss, as pelvi-ureteric junction obstruction (PUJO) is the most common uropathology found in of patients with antenatal hydronephrosis (HN; 30%), with no agreement regarding the ’gold standard’ investigation to use after pyeloplasty for PUJO. Methods: We retrospectively evaluated 130 paediatric patients with congenital PUJO in the period 2009–2013. Patients with bilateral PUJO or unilateral PUJO in a solitary kidney, associated with a dilated ureter or reflux, and patients with missed follow-up were excluded. We included only those with unilateral PUJO. Open dismembered pyeloplasty with stenting was the technique used in all cases. All patients were investigated postoperatively by multiple ultrasonographies and at least one diuretic renography. Results: In all, 95 patients with a mean (range) age of 48 (3–180) months were included. After a mean (range) follow-up period of 4 (2–6) years, we assessed outcomes. Overall, 70 patients (73.7%) showed improved HN, 20 (21%) had stable HN, and five (5.3%) had deteriorated and needed re-intervention. Of the improved group, 39 patients (55.7%) improved within the first 6 months and 59 (84.3%) by the end of the first postoperative year, whilst the remaining patients improved in a time range of 2–6 years. None of the improved or stable group had an obstructive washout curve. Conclusions: As most of the improvement occurs within the first 12 months after pyeloplasty, ultrasonography can be the single modality used for follow-up for the first year post-pyeloplasty for patients with improved HN and those with non-obstructive curves. Only for patients with unimproved HN by the end of the first year post-pyeloplasty, should further investigations be implemented to exclude obstruction.
format	article
author	Abdulhakim Alotay
author_facet	Abdulhakim Alotay
author_sort	Abdulhakim Alotay
title	[43] Post-pyeloplasty follow-up plan, less invasive plan
title_short	[43] Post-pyeloplasty follow-up plan, less invasive plan
title_full	[43] Post-pyeloplasty follow-up plan, less invasive plan
title_fullStr	[43] Post-pyeloplasty follow-up plan, less invasive plan
title_full_unstemmed	[43] Post-pyeloplasty follow-up plan, less invasive plan
title_sort	[43] post-pyeloplasty follow-up plan, less invasive plan
publisher	Taylor & Francis Group
publishDate	2018
url	https://doaj.org/article/bd6e34908b494004a3d972aed4b97e88
work_keys_str_mv	AT abdulhakimalotay 43postpyeloplastyfollowupplanlessinvasiveplan
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[43] Post-pyeloplasty follow-up plan, less invasive plan

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