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Ureteropelvic junction obstructions: prenatal diagnosis and neonatal surgery in 47 cases
J M Guys1, F Borella, G Monfort
1Department of Pediatric Surgery, School of Medicine of Marseille, France.
Insights
Neonatal repair of ureteropelvic junction obstruction shows excellent outcomes. Early surgical intervention using microsurgical techniques without stents or nephrostomy leads to favorable results in most pediatric patients.
Area of Science:
- Pediatric Urology
- Congenital Urologic Disorders
- Surgical Innovation
Background:
- Ureteropelvic junction (UPJ) obstruction is a common congenital urologic disorder.
- Management of UPJ obstruction in neonates requires careful consideration of surgical timing and technique.
Purpose of the Study:
- To evaluate the outcomes of neonatal repair for ureteropelvic junction obstruction.
- To compare results of neonatal repair with those of older patients operated on during the same period.
Main Methods:
- Retrospective analysis of 150 patients with congenital urologic disorders managed neonatally from 1980-1985.
- Focus on 48 cases of ureteropelvic junction obstruction, including surgical interventions (Anderson-Hynes pyeloplasty) and conservative management.
- Application of microsurgical techniques without stenting or nephrostomy.
Main Results:
- Out of 48 UPJ obstruction cases, 47 showed documented pyelocaliceal distension; 12 were bilateral.
- Five cases resolved spontaneously; three required nephrectomy.
- Fifty kidneys underwent Anderson-Hynes pyeloplasty with 90% reporting fair to excellent clinical, biological, and radiological outcomes.
- Postoperative complication rate was 6%.
Conclusions:
- Neonatal repair of ureteropelvic junction obstruction using microsurgical techniques without stents or nephrostomy yields favorable outcomes.
- Early surgical intervention in neonates is of significant interest and demonstrates comparable or improved results to older patient series.
Abstract:
In a series of 150 patients with congenital urologic disorders diagnosed in utero and managed in the neonatal period from 1980 to 1985, 48 cases were ureteropelvic junction obstructions. One was a false positive, and 47 were documented pyelocaliceal distension and retention; 12 of them were bilateral. Five cases had a spontaneous resolution. Three had a nephrectomy performed (destroyed kidney). Fifty kidneys have been operated on (Anderson-Hynes dysmembered pyeloplasty). Ninety percent of the cases are reported as clinically, biologically, and radiologically fair. Six percent postoperative complications are reported. The authors pointed out the great interest in neonatal repair of this condition, using microsurgical techniques without stent or nephrostomy. A comparison is made of the overall results with an identical series of older patients operated on during the same period.