Hungarian Radiology

[Follow-up of infants undergoing pyeloplasty: renal ultrasound and diuresis renography changes]

KIS Éva, NYITRAI Anna, VÁRKONYI Ildikó, BÁRTFAI Katalin, GYÖRKE Tamás, MÁTTYUS István, VEREBÉLY Tibor

AUGUST 20, 2003

Hungarian Radiology - 2003;77(04)

[INTRODUCTION - The authors reviewed their experience after pyeloplasty in infants, according to the follow-up results of ultrasound and nuclear renography. PATIENTS AND METHODS - During the period 1988-2001 184 infants underwent pyeloplasty for ureteropelvic junction (UPJ) obstruction. Patients (n=91) with unilateral UPJ obstruction and normal contralateral kidney were included in this study. Patients ages at surgery were between 1 day-36 months. Preoperative evaluation included ultrasound examinations and diuretic renograms. Follow-up ultrasound examinations were done after 3, 6, 12 months, later yearly. Depending on the result of the ultrasound examination isotope scan were done. RESULTS - The pelviureteric obstruction were detected prenatally at 65 cases (71%). Preoperative ultrasound revealed grade 3-4 pyelocaliectasis in all patients. All patients had obstruction on preoperative renography, nine kidneys had no function, in 37 cases (41%) hydronephrotic kidneys had diminished function. Nine patients underwent nephrectomy because of non-functioning kidney. Eighty two infants underwent pyeloplasty. Grade of hydronephrosis improved in 56% of kidneys and dilatation was the same one year after pyeloplasty in 44% of kidneys. Five years after pyeloplasty 91% of kidneys, after eight years 97% of hydronephrosis improved or cured. Postoperative renography showed improvement in drainage in all preoperatively obstructed kidneys. The renal function improved only in 22% of cases at the end of the first postoperative year, and no further improvement were detected later on. CONCLUSION - Pyeloplasty in infant ages significantly cured the drainage early after surgery. The resolution of hydronephrosis is relatively slow, but after eight years dilatation cured or improved in most of the affected kidneys. Improvement of the renal function was detected only in small part of the cases.]

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