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A Murine Model of Irreversible and Reversible Unilateral Ureteric Obstruction
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Long-term renal function post-pyeloplasty: a systematic review.
Roberto B I Christanto1, Putu Angga Risky Raharja2, Gerhard Reinaldi Situmorang1
1Department of Urology. Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.
International Urology and Nephrology
|April 9, 2025
Summary
Pyeloplasty surgery effectively improves or preserves kidney function in children with ureteropelvic junction obstruction (UPJO). Early intervention and minimally invasive techniques lead to the best long-term outcomes with minimal complications.
Area of Science:
- Pediatric Urology
- Nephrology
- Surgical Outcomes Research
Background:
- Ureteropelvic junction obstruction (UPJO) is a common cause of neonatal kidney dysfunction.
- Pyeloplasty is the standard surgical treatment, but its long-term efficacy requires further evaluation.
- Understanding long-term renal outcomes is crucial for managing pediatric UPJO.
Purpose of the Study:
- To systematically review the long-term impact of pyeloplasty on pediatric renal function.
- To assess quality-of-life and complication rates following pediatric pyeloplasty.
- To evaluate the durability of surgical correction for UPJO in children.
Main Methods:
- Systematic literature search of major databases (PubMed, Embase, Scopus, Cochrane).
- Inclusion of studies reporting long-term outcomes (≥2 years) of pediatric pyeloplasty.
- Narrative synthesis of data from 9 studies (n=836) focusing on renal function metrics and imaging.
Main Results:
- Pyeloplasty significantly improved renal function, especially in kidneys with low preoperative differential renal function (DRF).
- Up to 89% of cases showed preserved or enhanced renal function post-surgery, with frequent resolution of hydronephrosis.
- Minimally invasive pyeloplasty demonstrated efficacy comparable to open surgery, with minor complications.
Conclusions:
- Pyeloplasty offers durable success in improving or preserving renal function in pediatric UPJO.
- Antenatal diagnosis and early intervention are associated with optimal outcomes.
- Minimally invasive approaches provide benefits in recovery, and further research should focus on standardized monitoring.
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