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Predictors of Complications after Pediatric Pyeloplasty: A Retrospective Cohort Study and Meta-Analysis

Xintao Zhang1,2, Yu Zhou1, Chuncan Ma1

  • 1Department of Pediatric Surgery, Qilu Hospital of Shandong University, Jinan, China.

Journal of Endourology
|February 19, 2026
PubMed

Insights

Preoperative urinary tract infections and longer Double J-stent duration predict postpyeloplasty complications. Thinner renal cortical thickness is associated with fewer complications, aiding early intervention strategies.

Area of Science:

  • Pediatric Urology
  • Surgical Outcomes Research

Background:

  • Pyeloplasty is the standard treatment for ureteropelvic junction obstruction (UPJO).
  • Postoperative complications following pyeloplasty present a significant clinical challenge.
  • Predictors for these complications require further elucidation in current literature.

Purpose of the Study:

  • To identify key predictors of postpyeloplasty complications.
  • To analyze factors associated with total complications, recurrence, and postoperative urinary tract infections (UTIs).
  • To synthesize evidence through a systematic review and meta-analysis.

Main Methods:

  • Retrospective analysis of pediatric pyeloplasty cases (January 2011 - August 2022).
  • Systematic review and meta-analysis of studies published between 2000 and 2023.
  • Statistical analysis including odds ratios (OR) and relative risks (RR) with confidence intervals (CI).

Main Results:

  • Preoperative UTI, longer Double J-stent duration, and collection system separation predicted total complications.
  • Preoperative UTI, longer Double J-stent duration, and operation duration predicted recurrence.
  • Preoperative UTI and reduced renal cortical thickness predicted postoperative UTIs.
  • Sex, operation methods, and split renal function were identified as predictors in the meta-analysis.

Conclusions:

  • Several factors, including preoperative UTI and renal cortical thickness, significantly predict postpyeloplasty complications.
  • Early identification and management of these predictors can potentially reduce complication rates.
  • This study provides valuable insights for optimizing pyeloplasty outcomes.
Abstract

Keywords:
complicationsmeta-analysispediatricspyeloplastyureteral obstruction

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