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Giant hydronephrosis: still a reality!
Kawaljit Singh Kaura1, Manoj Kumar1, Ashok Kr Sokhal1
1Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India.
Turkish Journal of Urology
|September 2, 2017
Summary
Giant hydronephrosis (GH) requires prompt diagnosis and treatment to avoid kidney removal. Early intervention improves outcomes and reduces complications associated with this rare condition.
Area of Science:
- Urology
- Pediatric Urology
- Nephrology
Background:
- Giant hydronephrosis (GH) is a rare condition with fewer than 500 reported cases.
- Delayed diagnosis can lead to severe complications including hypertension, renal failure, and malignancy.
Purpose of the Study:
- To emphasize the significance of early diagnosis and management of GH.
- To establish a consensus for the timely detection and treatment of GH.
Main Methods:
- A retrospective study of 35 patients (adults and children) with GH from June 2013 to December 2015.
- Data collection included epidemiologic, radiological, perioperative, and follow-up information.
- All patients underwent percutaneous nephrostomy tube placement for initial management and diagnosis.
Main Results:
- The most common presentations were flank pain in adults and abdominal masses in children.
- Pelvi-ureteric junction obstruction (PUJO) was diagnosed in 91.4% of cases.
- Nephrectomy was performed in 37.1% of non-functioning kidneys; reduction pyeloplasty with nephropexy had an 81% success rate with a 23.1% complication rate.
Conclusions:
- Early diagnosis and management of GH are crucial.
- Prompt intervention can reduce the rate of nephrectomy and improve the success of conservative surgical procedures like pyeloplasty.
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