Related Experiment Video
Updated: Jul 13, 2025
Author Spotlight: Developing a Bedside Protocol for Kidney and Genitourinary Ultrasonography
Published on: June 21, 2024
Ureteropelvic junction obstruction with polyps in children: clinical manifestations and supranormal preoperative
Yuzhu He1, Yi Li1, Jihang Sun2
1Department of Urology, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, No. 56 Nanlishi St, Xicheng District, Beijing, 100045, China.
Insights
In UPJO children with polyps, preoperative renal function is often preserved, with nearly 40% showing supranormal function. These children can be managed similarly to those with normal renal function.
Area of Science:
- Pediatric Urology
- Nephrology
- Surgical Outcomes
Background:
- Ureteropelvic junction obstruction (UPJO) with polyps is a condition affecting children.
- Assessing preoperative renal function is crucial for surgical planning and prognosis.
Purpose of the Study:
- To analyze the clinical presentation and preoperative differential renal function (pre-DRF) in children with UPJO and polyps.
- To identify factors associated with supranormal pre-DRF in this patient group.
Main Methods:
- Retrospective review of 18 children undergoing Anderson-Hynes pyeloplasty for UPJO due to polyps.
- Analysis of patient demographics, ultrasound parameters, and dynamic renography (DR) data.
- Comparison of pre-DRF across different patient characteristics and sonographic findings.
Main Results:
- Nearly 40% of UPJO children with polyps presented with supranormal pre-DRF.
- Supranormal pre-DRF was more prevalent in younger, lower-weight children.
- Preoperative renal function was generally well-preserved, with most patients showing pre-DRF >40%.
Conclusions:
- Preoperative renal function in UPJO patients with polyps is typically maintained.
- A significant proportion of these patients exhibit supranormal pre-DRF.
- Management strategies for supranormal pre-DRF can align with those for normal renal function.
Objective:
To describe and analyze the clinical manifestation and pre-DRF of UPJO children with polyps and explore the possible influencing factors of supranormal pre-DRF.
Patients And Methods:
All patients undergoing primary Anderson-Hynes pyeloplasty for UPJO due to polyp were retrospectively reviewed. Patients' characteristics, parameters of ultrasound and dynamic renograms (DR) were recorded in elaborate. Pre-DRF in groups of different age, weight, gender, pain, grade of hydronephrosis, anterio-posterior pelvic diameter (APD), length of kidney and postoperative ultrasonic parameters were compared.
Results:
A total of 18 UPJO children with polyps were included. Five (27.78%) patients had SFU III grade of hydronephrosis. Seven (38.89%) patients were supranormal pre-DRF. All patients had pre-DRF > 40%. Drainage curve was delayed excretion in 12 (66.67%) patients and T1/2 < 20 min was in 4 (22.22%) patients. Among the 16 patients who underwent preoperative IVP examination, 15 (93.75%) patients had concentration of intrarenal pelvis contrast agent within 10 min. No significant difference in post-APD reduction rate and post-minPT increased was found between supranormal pre-DRF and non-supranormal pre-DRF groups. The supranormal pre-DRF was more likely to occur in young and low-weight children.
Conclusion:
The preoperative renal function of UPJO patients with polyps was well preserved, and 38.89% of them had supranormal pre-DRF. Patients with supranormal pre-DRF can be managed with the same strategies as those with normal renal function.
Related Concept Videos
01:22Imaging Studies V: Intravenous Urography and Retrograde Pyelography
01:26Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations
01:24Imaging Studies II: Ultrasonography
01:26Kidney Transplant II: Surgical Procedure
01:26Nursing Assessment of the Genitourinary System II: Inspection and Palpation
01:28Imaging Studies I: Kidney, Ureter, and Bladder Studies