Long-term functional and morphological outcome after pyeloplasty for huge renal pelvis.

Abstract:

OBJECTIVE:• To evaluate the functional and morphological outcome after open pyeloplasty for ureteropelvic junction obstruction (UPJO) with huge renal pelvis. PATIENTS AND METHODS:• A retrospective review of all cases who underwent pyeloplasty for huge renal pelvis was conducted. • Records were evaluated with respect to age at presentation, preoperative imaging, surgical details and postoperative course. Patients were followed up regularly for both functional and morphological outcome. • Success was defined as both symptomatic relief and radiographic resolution of obstruction at last follow-up. RESULTS:• Between 1998 and 2008, 526 cases of primary UPJO underwent open dismembered pyeloplasty at our centre. • Of these patients, 41 (8%) had UPJO with huge renal pelvis. • No perioperative complications were encountered in the study group. Mean (range) follow-up was 34 (18-84) months and nine patients were lost to follow-up. The overall success rate was 91%. • Two patients underwent redo pyeloplasty, whereas secondary nephrectomy was necessary in one. • Improvement of hydronephrosis was evident in all patients, except in three patients who underwent secondary procedures. • However, persistent obstruction on diuretic renography was seen in most cases (65%). CONCLUSIONS:• Open pyeloplasty for huge pelvis UPJO is feasible with a high success rate. • Varying degrees of hydronephrosis and radiological obstruction after pyeloplasty are not uncommon. • Nephrectomy is rarely indicated in cases with severely deteriorated renal function.

journal_name

BJU Int

journal_title

BJU international

authors

Sarhan O,Helmy T,Abou-El Ghar M,Baky MA,El-Assmy A,Dawaba M

doi

10.1111/j.1464-410X.2010.09566.x

subject

Has Abstract

pub_date

2011-03-01 00:00:00

pages

829-833

issue

5

eissn

1464-4096

issn

1464-410X

journal_volume

107

pub_type

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