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A Decrease in Longitudinal Length of Kidney is a Reliable Tool to Predict the Success of Pyeloplasty in Children
Dogancan Dorucu1, Kader Ada Dogan1, Onur Can Ozkan2
1Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey.
Summary
Kidney longitudinal length (LL) significantly decreases after pyeloplasty for ureteropelvic junction obstruction (UPJO). This reduction in LL may serve as a reliable alternative to renal pelvis anteroposterior diameter (RPAPD) for monitoring UPJO treatment outcomes.
Area of Science:
- Pediatric Urology
- Medical Imaging
- Surgical Outcomes
Background:
- Ureteropelvic junction obstruction (UPJO) is a common congenital anomaly.
- Renal pelvis anteroposterior diameter (RPAPD) is a key metric for UPJO diagnosis and management.
- Alternative, simpler measurements for UPJO follow-up are needed.
Purpose of the Study:
- To evaluate the utility of kidney dimensions, specifically longitudinal length (LL) and transverse width (TW), as alternatives to RPAPD.
- To assess the changes in kidney dimensions after pyeloplasty for UPJO.
Main Methods:
- Retrospective analysis of children undergoing pyeloplasty (2012-2024).
- Exclusion of cases with confounding urinary tract conditions.
- Comparison of ultrasound (US) measurements (RPAPD, hydronephrosis grade, LL, TW) pre- and post-surgery.
Main Results:
- A significant decrease in RPAPD and LL was observed 6 months post-pyeloplasty (p < 0.0001 and p = 0.005, respectively).
- The ratio of LL between affected and contralateral kidneys also significantly decreased (p = 0.026).
- No significant changes were noted in TW or its ratio.
Conclusions:
- Kidney longitudinal length (LL) is elevated in UPJO and significantly reduces after pyeloplasty.
- The decrease in LL offers a straightforward and reliable measurement for post-pyeloplasty follow-up.
- LL may serve as a valuable adjunct or alternative to RPAPD in managing UPJO.
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