Factors Affecting The Short Term Outcome Of Pyeloplasty In Congenital Primary Unilateral Pelvi- Ureteric Junction Obstruction In Infants and Toddlers: A Single Center trial
Background: Congenital ureteropelvic junction obstruction (UPJO) is by far the most common cause of pediatric hydronephrosis. UPJO standard surgical treatment is open dismembered pyeloplasty (Andersons-Hyens). Aim of the work: To study the morphological and functional outcome of dismembered pyelopl...
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Cairo University, Faculty of Medicine, Department of Pediatrics
2025-01-01
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| Series: | Pediatric Sciences Journal |
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| Online Access: | https://cupsj.journals.ekb.eg/article_387136_d7ab788a5f0253d07fb33c67aca6a899.pdf |
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| author | Mostafa Sheba Walid Ghoneima Mohamed El Ghoneimy Amr Mostafa Ahmed Salem |
| author_facet | Mostafa Sheba Walid Ghoneima Mohamed El Ghoneimy Amr Mostafa Ahmed Salem |
| author_sort | Mostafa Sheba |
| collection | DOAJ |
| description | Background: Congenital ureteropelvic junction obstruction (UPJO) is by far the most common cause of pediatric hydronephrosis. UPJO standard surgical treatment is open dismembered pyeloplasty (Andersons-Hyens).
Aim of the work: To study the morphological and functional outcome of dismembered pyeloplasty in infants and toddlers with unilateral UPJO.
Materials and Methods: This prospective study was carried on 50 infants and toddlers aged 2 months - 36 months with unilateral UPJO at Cairo University Children Hospital.
Results: The mean age of studied group was 11 ± 3 months. The main symptom was recurrent urinary tract infect in 18 (36%) of cases, followed by loin pain in 12 (24%), hematuria in 4(8%) and 16 (32%). Initial pre-operative ultrasound demonstrated moderate and severe hydronephrosis (HN) in 29 (58%) and 21 (42%) of the cases, mean cortical thickness was 6.78 ± 1.57 cm and mean anteroposterior (AP) diameter was 3.27± 0.58 cm. After 3 and 6 months, 24(48%) and 30 (60%) had mild degree of HN, 23 (46%) and 17 (34%) had moderate HN and 3 (6%) and 3 (6%) had severe HN respectively (p=0.000). The mean cortical thickness increased to 8.66 ± 1.49 mm (p=0.000). The mean AP dropped substantially as well to 2.7± 0.57 cm (p=0.000). Operative time did not influence outcome (p=0.653), yet pre-operative lesser degree of HN, more cortical thickness and lesser AP diameter was associated with better outcome (p=0.000, p=0.000 and p=0.000 respectively). Those with younger age at presentation had better outcome (p=0.001)
Conclusion: The better outcome of dismembered pyeloplasty (Andersons-Hyens) relies on early diagnosis and implementation before development of HN, cortical thickness erosion and increase in AP diameter. Pyeloplasty for unilateral UPJO in younger age seems to allow cortical remodeling and regeneration. Long term follow up remains crucial to verify the long term outcome. |
| format | Article |
| id | doaj-art-5a76800a530e4fe488de9370b3589371 |
| institution | Kabale University |
| issn | 2805-279X 2682-3985 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cairo University, Faculty of Medicine, Department of Pediatrics |
| record_format | Article |
| series | Pediatric Sciences Journal |
| spelling | doaj-art-5a76800a530e4fe488de9370b35893712025-01-07T10:40:05ZengCairo University, Faculty of Medicine, Department of PediatricsPediatric Sciences Journal2805-279X2682-39852025-01-0151354110.21608/CUPSJ.2024.302955.1138Factors Affecting The Short Term Outcome Of Pyeloplasty In Congenital Primary Unilateral Pelvi- Ureteric Junction Obstruction In Infants and Toddlers: A Single Center trialMostafa Sheba0https://orcid.org/0000-0002-5213-1411Walid Ghoneima1Mohamed El Ghoneimy2Amr Mostafa3Ahmed Salem4Department of Urology, Faculty of Medicine, Cairo University, EgyptDepartment of Urology, Faculty of Medicine, Cairo University, EgyptDepartment of Urology, Faculty of Medicine, Cairo University, EgyptDepartment of Urology, Faculty of Medicine, Cairo University, EgyptDepartment of Urology, Faculty of Medicine, Cairo University, EgyptBackground: Congenital ureteropelvic junction obstruction (UPJO) is by far the most common cause of pediatric hydronephrosis. UPJO standard surgical treatment is open dismembered pyeloplasty (Andersons-Hyens). Aim of the work: To study the morphological and functional outcome of dismembered pyeloplasty in infants and toddlers with unilateral UPJO. Materials and Methods: This prospective study was carried on 50 infants and toddlers aged 2 months - 36 months with unilateral UPJO at Cairo University Children Hospital. Results: The mean age of studied group was 11 ± 3 months. The main symptom was recurrent urinary tract infect in 18 (36%) of cases, followed by loin pain in 12 (24%), hematuria in 4(8%) and 16 (32%). Initial pre-operative ultrasound demonstrated moderate and severe hydronephrosis (HN) in 29 (58%) and 21 (42%) of the cases, mean cortical thickness was 6.78 ± 1.57 cm and mean anteroposterior (AP) diameter was 3.27± 0.58 cm. After 3 and 6 months, 24(48%) and 30 (60%) had mild degree of HN, 23 (46%) and 17 (34%) had moderate HN and 3 (6%) and 3 (6%) had severe HN respectively (p=0.000). The mean cortical thickness increased to 8.66 ± 1.49 mm (p=0.000). The mean AP dropped substantially as well to 2.7± 0.57 cm (p=0.000). Operative time did not influence outcome (p=0.653), yet pre-operative lesser degree of HN, more cortical thickness and lesser AP diameter was associated with better outcome (p=0.000, p=0.000 and p=0.000 respectively). Those with younger age at presentation had better outcome (p=0.001) Conclusion: The better outcome of dismembered pyeloplasty (Andersons-Hyens) relies on early diagnosis and implementation before development of HN, cortical thickness erosion and increase in AP diameter. Pyeloplasty for unilateral UPJO in younger age seems to allow cortical remodeling and regeneration. Long term follow up remains crucial to verify the long term outcome.https://cupsj.journals.ekb.eg/article_387136_d7ab788a5f0253d07fb33c67aca6a899.pdfpediatric pelvi-ureteric junction obstructionpyeloplastyrenogramsurgical outcome |
| spellingShingle | Mostafa Sheba Walid Ghoneima Mohamed El Ghoneimy Amr Mostafa Ahmed Salem Factors Affecting The Short Term Outcome Of Pyeloplasty In Congenital Primary Unilateral Pelvi- Ureteric Junction Obstruction In Infants and Toddlers: A Single Center trial Pediatric Sciences Journal pediatric pelvi-ureteric junction obstruction pyeloplasty renogram surgical outcome |
| title | Factors Affecting The Short Term Outcome Of Pyeloplasty In Congenital Primary Unilateral Pelvi- Ureteric Junction Obstruction In Infants and Toddlers: A Single Center trial |
| title_full | Factors Affecting The Short Term Outcome Of Pyeloplasty In Congenital Primary Unilateral Pelvi- Ureteric Junction Obstruction In Infants and Toddlers: A Single Center trial |
| title_fullStr | Factors Affecting The Short Term Outcome Of Pyeloplasty In Congenital Primary Unilateral Pelvi- Ureteric Junction Obstruction In Infants and Toddlers: A Single Center trial |
| title_full_unstemmed | Factors Affecting The Short Term Outcome Of Pyeloplasty In Congenital Primary Unilateral Pelvi- Ureteric Junction Obstruction In Infants and Toddlers: A Single Center trial |
| title_short | Factors Affecting The Short Term Outcome Of Pyeloplasty In Congenital Primary Unilateral Pelvi- Ureteric Junction Obstruction In Infants and Toddlers: A Single Center trial |
| title_sort | factors affecting the short term outcome of pyeloplasty in congenital primary unilateral pelvi ureteric junction obstruction in infants and toddlers a single center trial |
| topic | pediatric pelvi-ureteric junction obstruction pyeloplasty renogram surgical outcome |
| url | https://cupsj.journals.ekb.eg/article_387136_d7ab788a5f0253d07fb33c67aca6a899.pdf |
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