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The effect of pyeloplasty age on postoperative renal function and antero-posterior diameter (APD) in prenatally diagnosed Ureteropelvic junction Obstruction：Indications for the timing of pyeloplasty
Abstract
OBJECTIVE
To evaluate the renal function and percent improvement in the antero-posterior diameter (PI-APD) outcome in different operation age for ureteropelvic junction obstruction (UPJO) with antenatal diagnosed .
PATIENTS AND METHODS
* A retrospective review cases that under 3 years who underwent pyeloplasty from 2011 to 2015 for UPJO with prenatally diagnosed in single centre. All patients were underwent and recorded renal ultrasonography and diethylene triamine pentaacetic acid (DTPA) scans for preoperative and postoperative. Anderson-Hynes dismembered pyeloplasty was carried out for all cases.
* Records were evaluated with respect to age at operation, preoperative antero-posterior diameter (APD), preoperative split renal function（SRF）and postoperative course.
*Considered the PI-APD>40% or SRF was improved by >5% whose underwent pyeloplasty is improvement, analyzed improvement and un-improvement patients' age.
RESULTS
* In the period 2011 to 2015, 49 cases aged <3 years of prenatally diagnosed UPJO underwent dismembered pyeloplasty with clinic date completion in our centre.
* Of these patients, male (n=46, 94%) and female (n=3, 6%) were in our study, from 1 month to 36 month, with the median age of 3.8 months. Follow-up time ranged 6 to 12 months.
* A statisitically significant different between before and after operation APD(P=0.000) or SRF(P=0.046) under the Wilcoxon rank sum Tests. There was a significant negative correlation between the age of surgery and PI-APD (R=-0.340, P=0.017). And significant negative correlation were observed between the age and improvement SRF>5% ( R=-0.382, P=0.007)
* 5 patients underwent redo double –J stent cathelerization because hydronephrosis aggravate in follow-up. The overall success rate was 89.7%.
CONCLUSIONS
* The age of pyeloplasty maybe a factor to outcome for spilt renal functional and PI-APD.
* Once a UPJO patient has a operation indication , allow appropriate early time for under surgery intervence is necessary.
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