Our experience of operated pediatric ureteropelvic junction obstruction patients

Abstract

Aims: Ureteropelvic junction obstruction (UPJO) may originate from extrinsic or intrinsic causes in children. The aim of this study is to present preoperative and postoperative data of our patients operated for UPJO. Methods: A total of 64 patients who underwent open pyeloplasty were investigated retrospectively. They were evaluated in terms of demographically, clinics, hydronephrosis, differential renal functions (DRFs), half-time tracer clearance (½TC), and histopathologic results. Patients’ numerical results were stated as mean ± standard deviation (SD). Results: Male gender was more prevalent ( n = 47, 73.4%) and mean age at surgery was 46.87 months. UPJO was located at the left side in 56.3% ( n = 36), and at the right side in 39.1% ( n = 25) of patients. It was bilateral in 4.7% ( n = 3). Hydronephrosis was found antenatally in 68.8% ( n = 44) of patients. The mean preoperative DRF was 49.7% (21–78%) and mean postoperative DRF was 49.2% (20–56%). Mean renal scintigraphic t1/2 was >20 min for all patients. The mean AP diameter was 21.58 mm (10–62 mm). Muscular hypertrophy was the most common pathological finding, mean length of excised segment was 10.26 mm (3–40 mm). Crossing vessel (CV) was detected in 17.18% ( n = 11). The CV was statistically associated with increased age of operation, left side, and female gender. Statistically significant hydronephrosis was found in non-CV patients. Re-operation was required in seven patients (7.8%). Conclusions: Intrinsic pathologies are more seen in the etiology of UPJO patients with antenatal diagnosis and this group needs operation at an earlier age. However, CV is found more commonly in patients who are diagnosed and operated at older ages.