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Updated: Jun 10, 2026

Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis

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Published on: July 8, 2025

Is routine renography required after pyeloplasty?

Fayez Almodhen¹, Roman Jednak, John-Paul Capolicchio

¹Division of Pediatric Urology, Montreal Children's Hospital and McGill University Health Center, Montreal, Quebec, Canada.

The Journal of Urology

|July 24, 2010

Summary

Postoperative renal scans may not be routinely needed after pyeloplasty if ultrasound shows improvement. However, renal scans are valuable for patients with less than 45% preoperative split renal function to detect functional changes.

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Published on: April 28, 2023

Area of Science:

Pediatric surgery
Urology
Radiology

Background:

Pyeloplasty is a common procedure for ureteropelvic junction obstruction.
Assessing the effectiveness of pyeloplasty often involves imaging and functional tests.

Purpose of the Study:

To evaluate the necessity of routine postoperative renography following pyeloplasty.
To determine the utility of renal scans in assessing outcomes after pyeloplasty.

Main Methods:

Retrospective review of 97 patients undergoing 101 pyeloplasties (1989-2005).
Inclusion criteria: preoperative and postoperative ultrasound and renal scans.
Exclusion criteria: associated anomalies or high-grade reflux.

Main Results:

2% of improved kidneys (ultrasound) showed transient obstruction on renal scan.
40% of non-improved kidneys (ultrasound) had obstructive renal scans, with 50% requiring reoperation.
Kidneys with downgraded hydronephrosis on ultrasound showed no obstruction on renal scan (p<0.03).
43% of patients with <45% preoperative split renal function showed >5% functional change postoperatively (p<0.001).

Conclusions:

Postoperative renal scan may be unnecessary when ultrasound indicates improvement (downgrading) after pyeloplasty.
Renal scans are beneficial for patients with preoperative split renal function <45% to monitor functional changes.