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Ureteropelvic junction obstructions: Is side a prognostic factor?
1Department of Pediatric Surgery, Health Sciences University Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey.
Left-sided ureteropelvic junction obstruction (UPJO) is more common and severe than right-sided UPJO. Surgical management shows differing impacts on kidney function based on laterality.
Area of Science:
- Urology
- Pediatric Surgery
- Nephrology
Background:
- Ureteropelvic junction obstruction (UPJO) is more prevalent on the left side.
- Neonatal left-side UPJO cases exhibit a more severe clinical course compared to right-sided cases.
Purpose of the Study:
- To evaluate clinical advancements in surgical management for symptomatic right and left UPJOs.
- To compare preoperative and postoperative outcomes based on laterality.
Main Methods:
- Retrospective analysis of 650 patients diagnosed with UPJO.
- Evaluation of clinical data at diagnosis, surgery, and during postoperative follow-up.
Main Results:
- Left-side UPJO occurred in 66.1% of patients, with surgery at a median age of 1.5 years versus 4.2 years for right-side UPJO.
- Preoperative parenchymal thickness ratio differed significantly between left (0.55) and right (0.7) UPJO sides.
- Left UPJO group showed a significant decline in kidney function (42.5 to 39.52) at 3 years, while the right group improved (38.8 to 40.2).
Conclusions:
- Left-sided UPJO presents a more severe clinical course than right-sided UPJO.
- Surgical outcomes indicate differential effects on renal function recovery based on the side of UPJO.
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