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

Osama Sarhan1, Tamer Helmy1, Mohamed Abou-El Ghar1

  • 1Urology and Nephrology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

BJU International
|August 26, 2010
PubMed

Insights

Open pyeloplasty is a successful treatment for ureteropelvic junction obstruction (UPJO) with a huge renal pelvis, achieving a 91% success rate. While hydronephrosis may persist radiologically, functional outcomes are generally positive.

Area of Science:

  • Urology
  • Pediatric Surgery
  • Surgical Outcomes

Background:

  • Ureteropelvic junction obstruction (UPJO) can present with a significantly dilated renal pelvis.
  • Evaluating surgical outcomes in UPJO with a huge renal pelvis is crucial for patient management.

Purpose of the Study:

  • To assess the functional and morphological results of open pyeloplasty in patients with UPJO and a huge renal pelvis.

Main Methods:

  • Retrospective review of 41 patients who underwent open pyeloplasty for UPJO with a huge renal pelvis between 1998 and 2008.
  • Evaluation of preoperative imaging, surgical details, and postoperative course, with follow-up for functional and morphological outcomes.
  • Success defined by symptomatic relief and radiographic resolution of obstruction.

Main Results:

  • The overall success rate for open pyeloplasty was 91% in this cohort.
  • Improvement in hydronephrosis was observed in most patients, though 65% showed persistent obstruction on diuretic renography.
  • No perioperative complications occurred; secondary procedures (redo pyeloplasty or nephrectomy) were rarely needed.

Conclusions:

  • Open pyeloplasty is a feasible and highly successful surgical option for UPJO with a huge renal pelvis.
  • Persistent hydronephrosis and radiological obstruction are not uncommon post-pyeloplasty but do not always correlate with poor functional outcomes.
  • Nephrectomy is seldom required, even in cases with significant renal function deterioration.
Abstract

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