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Scintigraphic renal function after unilateral pyeloplasty in children: a systematic review

Marco Castagnetti1, Giacomo Novara, Francesco Beniamin

  • 1Section of Paediatric Urology, Urology Unit, University Hospital of Padova, Padova, Italy. marcocastagnetti@hotmail.com

BJU International
|March 14, 2008
PubMed

Insights

Pyeloplasty improves kidney function in children with unilateral hydronephrosis. Functional outcomes are better for symptomatic, postnatally diagnosed patients with moderate preoperative impairment.

Area of Science:

  • Pediatric Urology
  • Nephrology
  • Surgical Outcomes

Background:

  • Unilateral hydronephrosis in children often results from pelvi-ureteric junction obstruction.
  • Pyeloplasty is the standard surgical treatment for this condition.
  • Understanding factors influencing functional outcomes is crucial for patient management.

Purpose of the Study:

  • To systematically review existing literature on functional outcomes following pyeloplasty in pediatric unilateral hydronephrosis.
  • To identify variables that may impact the success of pyeloplasty.

Main Methods:

  • A comprehensive literature search was conducted across major databases (Medline/PubMed, Embase, Web of Science) from 1966 to 2007.
  • Studies reporting scintigraphic renal function before and after pyeloplasty were selected.
  • Postoperative functional changes were analyzed in relation to clinical presentation, surgical timing, patient age, and preoperative imaging findings.

Main Results:

  • Thirty-six studies were included, noted for poor quality and heterogeneity.
  • Postoperative renal function demonstrated significant variability.
  • Symptomatic, postnatally diagnosed patients and those with moderate preoperative impairment showed a higher likelihood of functional improvement.

Conclusions:

  • Pyeloplasty offers functional improvement in pediatric unilateral hydronephrosis.
  • Patient presentation (symptomatic vs. asymptomatic) and degree of preoperative renal function impairment are key predictors of success.
  • Surgical timing and age at surgery appear less influential on functional outcomes.
Abstract

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