Related Experiment Video

Updated: Aug 1, 2026

An Immature Murine Model of Reversible Unilateral Ureteral Obstruction
06:37

An Immature Murine Model of Reversible Unilateral Ureteral Obstruction

Published on: April 4, 2025

Does delaying pyeloplasty affect renal function in children with a prenatal diagnosis of pelvi-ureteric junction

B Chertin1, U Rolle, A Farkas

  • 1Children's Research Centre, Our Lady's Hospital for Sick Children, Crumlin, Dublin, Ireland.

BJU International
|June 26, 2002
PubMed

Insights

Expectant management is recommended for antenatal pelvi-ureteric junction (PUJ) obstruction. Delayed pyeloplasty effectively restores renal function even after deterioration, sparing children unnecessary early surgery.

Area of Science:

  • Pediatric Urology
  • Nephrology
  • Surgical Outcomes

Background:

  • Pelvi-ureteric junction (PUJ) obstruction is a common congenital anomaly.
  • Antenatal diagnosis allows for monitoring and selective intervention.
  • Deterioration of renal function is a key indicator for surgical consideration.

Purpose of the Study:

  • To evaluate renal function recovery after pyeloplasty in children with antenatal PUJ obstruction and deteriorating function.
  • To assess the effectiveness of delayed pyeloplasty in preserving or restoring kidney function.

Main Methods:

  • Retrospective analysis of 44 children with antenatal PUJ obstruction initially managed expectantly.
  • Exclusion criteria included bilateral disease, single kidney, or vesico-ureteric reflux.
  • Pyeloplasty was performed due to a >5% decline in renal function confirmed by scintigraphy.

Main Results:

  • All patients showed improved hydronephrosis post-pyeloplasty.
  • 81% (36/44) of patients regained their initial renal function levels within 6-12 months.
  • No significant correlation found between preoperative factors and functional recovery.

Conclusions:

  • Expectant management is a viable initial approach for antenatal PUJ obstruction.
  • Delayed pyeloplasty is effective in restoring renal function, even after documented deterioration.
  • This approach can prevent unnecessary surgical interventions in select pediatric cases.
Abstract

More Related Videos

Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis03:57

Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis

Published on: July 8, 2025

A Mouse Model to Evaluate the Long-Term Structural and Functional Outcomes after the Reversal of Prolonged Unilateral Ureteric Obstruction05:34

A Mouse Model to Evaluate the Long-Term Structural and Functional Outcomes after the Reversal of Prolonged Unilateral Ureteric Obstruction

Published on: July 18, 2025

Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Urinary Tract Calculi III: Medical Management01:30

Urinary Tract Calculi III: Medical Management

The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
Urinary Tract Calculi VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...
Imaging Studies V: Intravenous Urography and Retrograde Pyelography01:22

Imaging Studies V: Intravenous Urography and Retrograde Pyelography

IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...