Bilateral ureteropelvic junction obstruction: Factors guiding management
Journal Title: Indian Journal of Child Health - Year 2018, Vol 5, Issue 11
Abstract
Background: The management of prenatally detected hydronephrosis due to bilateral ureteropelvic junction obstruction (UPJO) remains controversial. No definite recommendations exist regarding management, and many authors recommend unilateral or bilateral pyeloplasty. Objective: This study was conducted to evaluate the clinical outcome of patients with bilateral UPJO treated at a tertiary care hospital. Materials and Methods: This descriptive study was performed in the Department of Pediatric Surgery, Lucknow. All patients with prenatally diagnosed bilateral hydronephrosis and postnatal diagnosis of bilateral UPJO, who underwent initial unilateral pyeloplasty, were prospectively evaluated and were included in the study. The outcome of contralateral hydronephrosis was assessed as resolution or surgery. Results: A total of 16 patients underwent initial unilateral pyeloplasty and met the inclusion criteria (mean age: 2.6 months). Of all 16 patients, 12 (75%) had resolution and 4 (25%) patients required additional contralateral pyeloplasty during the follow-up. The mean follow-up period was 18 months (range 9–36 months) and the mean anteroposterior pelvic diameter and pelvis-to-cortex (P/C) were significantly different among the groups (p<0.01). Conclusion: Our findings suggest that in children with bilateral UPJO type of hydronephrosis, improvement or resolution of the contralateral renal unit can occur following initial unilateral pyeloplasty for the worse renal unit. In patients in whom both the renal units have similar split renal function and grades of hydronephrosis, pelvic AP diameter, cortical thickness, and P/C ratio can be used to determine the likelihood of contralateral delayed pyeloplasty.
Authors and Affiliations
Ankur Mandelia, Rajnikant Yadav, Navdeep Singh Dhoat
Keywords
Related Articles
- EP ID EP473973
- DOI -
- Views 60
- Downloads 0
A case report on an unusual case of gait abnormality
Vitamin D3 (cholecalciferol) is a fat-soluble vitamin that is essential for the skeletal health. Here, we discuss a case of a child from an upper middle-class family who presented with gradually progressive proximal myop...
Nonsurgical device closure of isolated ostium secundum atrial septal defect in a case of genetically proven tuberous sclerosis
Tuberous sclerosis (TSC) is an autosomal dominant multisystem disease associated with multiple cardiac Rhabdomyomas; however, congenital cardiac malformations are very rare in TSC. A 5-year-old girl with classical featur...
Scrub typhus in children: Clinical profile and complications at a Tertiary Care Teaching Hospital in Uttarakhand
Background: Scrub typhus is an acute febrile illness caused by rickettsia Orientia tsutsugamushi. Rickettsial infections are grossly underdiagnosed in India because of their non-specific clinical presentation, low index...
Clinical profile of anemia among 6–60-month children living in South Karnataka – A cross sectional study
Introduction: Anemia is a worldwide public health problem and has a variable impact on the physical development of child. This study aims to assess the epidemiological characteristics and clinical profile of anemia among...
McCune-Albright syndrome without endocrine dysfunction: Case report in a young boy
The McCune-Albright syndrome (MAS) is a sporadic rare disease characterized by a triad of physical signs: Café-au lait spots, polyostotic fibrous dysplasia, and autonomous endocrine hyperfunction. Based on the studies, i...