Related Experiment Video
Updated: May 7, 2026
03:57
Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis
Published on: July 8, 2025
Failed pyeloplasty in children: revisiting the unknown.
Rodrigo L P Romao1, Martin A Koyle, Joao L Pippi Salle
1The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada; IWK Health Centre, Dalhousie University, Halifax, NS, Canada.
Urology
|September 17, 2013
Summary
Pediatric pyeloplasty failure occurs in 5.9% of cases. More invasive procedures like redo pyeloplasty offer higher success rates for treating failed pyeloplasty in children.
Area of Science:
- Pediatric Urology
- Surgical Management
- Renal Health
Background:
- Pyeloplasty is a common procedure for ureteropelvic junction obstruction in children.
- Management of failed pyeloplasty is not standardized, presenting a challenge in pediatric urology.
Purpose of the Study:
- To critically analyze the management strategies for pediatric failed pyeloplasty.
- To evaluate the success rates of different reintervention modalities.
Main Methods:
- Retrospective review of pediatric pyeloplasty cases from 2000-2010.
- Analysis of all reinterventions (excluding stent removal) for pyeloplasty failure.
- Data included demographics, initial surgery details, failure diagnosis, and reintervention outcomes.
Main Results:
- The pyeloplasty failure rate was 5.9% (27/455).
- Reintervention success rates varied: ureterocalicostomy (100%), redo pyeloplasty (92%), endopyelotomy (50%), and double J stent insertion (6%).
- Most patients required multiple reinterventions, with a mean follow-up of 56 months indicating long-term stability.
Conclusions:
- Definitive surgical techniques like redo pyeloplasty and ureterocalicostomy demonstrate superior success rates for failed pyeloplasty.
- Minimally invasive approaches have lower success rates in this cohort.
- Earlier consideration of more invasive, definitive procedures may be warranted for pediatric failed pyeloplasty.
Related Concept Videos
01:26Kidney 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...
01:22Imaging 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...
01:25Urinary 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...
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...