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Related Experiment Videos

Hydronephrosis After Pyeloplasty: "Will It Go Away?"

Christina P Carpenter1, Elizabeth Tolley2, Elizabeth Tourville3

  • 1Department of Urology, Division of Pediatric Urology, Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, TN; Department of Urology, Division of Pediatric Urology, Morgan Stanley Children's Hospital of New York, Columbia University Medical Center, New York, NY.

Urology
|August 21, 2018
PubMed
Summary

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Complete resolution of pediatric hydronephrosis after ureteropelvic junction obstruction surgery is rare and unpredictable. Parents should expect some dilatation to persist postoperatively, even with improved anteroposterior diameter measurements.

Area of Science:

  • Pediatric Urology
  • Surgical Outcomes
  • Medical Imaging

Background:

  • Ureteropelvic junction obstruction is a common cause of pediatric hydronephrosis.
  • Postoperative hydronephrosis dilatation can cause caregiver distress due to unpredictable resolution.
  • Recent literature suggests >20% improvement in anteroposterior diameter (APD) indicates resolution.

Purpose of the Study:

  • Identify predictors of hydronephrosis resolution after ureteropelvic junction obstruction surgery in children.
  • Provide data to guide clinicians in counseling families on expected outcomes.
  • Evaluate the significance of anteroposterior diameter (APD) changes post-pyeloplasty.

Main Methods:

  • Retrospective review of pediatric patients undergoing surgery for ureteropelvic junction obstruction (2010-2017).

Related Experiment Videos

  • Documented pre- and postoperative renal pelvis anteroposterior diameter (APD) measurements.
  • Statistical analysis of clinical and surgical variables impacting hydronephrosis resolution.

    • Main Results:

    • Complete resolution of hydronephrosis (APD=0) occurred in 11.5% at 3 months and 13.8% at 1.9 years post-surgery.
    • No analyzed variables significantly predicted complete resolution.
    • 80.6% of non-resolved cases showed >20% APD improvement; 3 required reoperation, none with >43% APD reduction.

    Conclusions:

    • Complete resolution of hydronephrosis post-ureteropelvic junction obstruction surgery is uncommon and unpredictable.
    • Counsel caregivers that dilatation often persists after surgical correction.
    • Significant APD reduction (>43%) may indicate lower risk of reintervention.