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Updated: Aug 19, 2026

Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis
03:57

Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis

Published on: July 8, 2025

Risk factors for pressure alopecia after pyeloplasty in children

Yang Zhao1, Xiaowei Zhang1,2, Xiaoli Shen1

  • 1Senior Department of Pediatrics, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.

Frontiers in Pediatrics
|August 18, 2026
PubMed

Insights

Prolonged head compression and lack of repositioning during pediatric pyeloplasty increase the risk of pressure alopecia (PA). Limiting head compression to under 3.5 hours can help prevent PA in children.

Area of Science:

  • Pediatric Urology
  • Surgical Complications
  • Alopecia Research

Background:

  • Minimally invasive pyeloplasty is a common procedure for pediatric hydronephrosis.
  • Postoperative pressure alopecia (PA) is a recognized complication following such procedures.
  • Understanding risk factors is crucial for preventing PA in pediatric patients.

Purpose of the Study:

  • To identify risk factors associated with pressure alopecia (PA) after pediatric pyeloplasty.
  • To propose preventive strategies for PA in children undergoing pyeloplasty.

Main Methods:

  • Retrospective analysis of 288 pediatric patients undergoing minimally invasive pyeloplasty.
  • Comparison of demographics, head compression duration, and intraoperative positioning between patients with and without PA.
  • Multivariate logistic regression and ROC curve analysis to identify independent risk factors and predictive values.

Main Results:

  • 22 out of 288 children (7.64%) developed postoperative PA.
  • Lack of intraoperative head repositioning (OR=6.00) and prolonged head compression (OR=2.90) were independent risk factors for PA.
  • Head compression duration >3.5 hours was identified as a significant predictor of PA with 86.8% sensitivity.

Conclusions:

  • Absence of regular intraoperative head repositioning and prolonged head compression are key risk factors for PA post-pediatric pyeloplasty.
  • Head compression exceeding 3.5 hours significantly elevates the risk of developing PA.
  • Strengthening intraoperative head positioning management and implementing targeted protective measures are recommended to prevent PA.
Abstract

Keywords:
childrenmanagementpressure alopeciapyeloplastyrisk factors

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