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• W1968291209 abstract "No AccessJournal of UrologySection on Urology American Academy of Pediatrics1 Oct 2009Does Renal Function Remain Stable After Puberty in Children With Prenatal Hydronephrosis and Improved Renal Function After Pyeloplasty? Boris Chertin, Avner Pollack, Dmitry Koulikov, Ron Rabinowitz, Ori Shen, Daniel Hain, Irit Hadas-Halpren, and Amicur Farkas Boris ChertinBoris Chertin Department of Urology, Shaare Zedek Medical Center, Jerusalem, Faculty of Medical Science, Hebrew University, Jerusalem, Israel Department of Urology (Division of Pediatric Urology), Shaare Zedek Medical Center, Jerusalem, Faculty of Medical Science, Hebrew University, Jerusalem, Israel More articles by this author , Avner PollackAvner Pollack Department of Urology, Shaare Zedek Medical Center, Jerusalem, Faculty of Medical Science, Hebrew University, Jerusalem, Israel Department of Urology (Division of Pediatric Urology), Shaare Zedek Medical Center, Jerusalem, Faculty of Medical Science, Hebrew University, Jerusalem, Israel More articles by this author , Dmitry KoulikovDmitry Koulikov Department of Urology, Shaare Zedek Medical Center, Jerusalem, Faculty of Medical Science, Hebrew University, Jerusalem, Israel More articles by this author , Ron RabinowitzRon Rabinowitz Obstetric Ultrasound Unit, Shaare Zedek Medical Center, Jerusalem, Faculty of Medical Science, Hebrew University, Jerusalem, Israel More articles by this author , Ori ShenOri Shen Obstetric Ultrasound Unit, Shaare Zedek Medical Center, Jerusalem, Faculty of Medical Science, Hebrew University, Jerusalem, Israel More articles by this author , Daniel HainDaniel Hain Department of Nuclear Medicine, Shaare Zedek Medical Center, Jerusalem, Faculty of Medical Science, Hebrew University, Jerusalem, Israel More articles by this author , Irit Hadas-HalprenIrit Hadas-Halpren Department of Diagnostic Radiology, Shaare Zedek Medical Center, Jerusalem, Faculty of Medical Science, Hebrew University, Jerusalem, Israel More articles by this author , and Amicur FarkasAmicur Farkas Department of Urology, Shaare Zedek Medical Center, Jerusalem, Faculty of Medical Science, Hebrew University, Jerusalem, Israel Department of Urology (Division of Pediatric Urology), Shaare Zedek Medical Center, Jerusalem, Faculty of Medical Science, Hebrew University, Jerusalem, Israel More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2009.03.008AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated whether improved renal function after pyeloplasty for prenatal ureteropelvic junction obstruction persisted through puberty. Materials and Methods: A total of 441 males and 137 females with a prenatal diagnosis of hydronephrosis that led to the postnatal diagnosis of ureteropelvic junction obstruction were followed at our department from 1989 to 2008. Of the patients we reviewed the records of 49 who underwent surgery between 1989 and 1992, and completed puberty. Hydronephrosis was on the right side in 18 children (36.7%) and on the left side in 31 (63.3%). According to Society for Fetal Urology classification at first presentation postnatal hydronephrosis was grades 2 to 4 in 18 (36.7%), 23 (46.9%) and 8 children (16.3%), respectively. Initially relative renal function was more than 40% in 18 children (36.7%), between 30% and 40% in 24 (49%), and less than 30% in 7 (14.3%). Preoperatively mean ± SEM relative renal function was 36.6% ± 7.8% in all reviewed patients. Results: Improvement in hydronephrosis was confirmed in all patients. This remained stable during and after puberty in all except 2 patients, who required endopyelotomy 8 and 10 years following pyeloplasty, respectively, due to deterioration in hydronephrosis without a decrease in relative renal function. They showed improvement in the washout curve pattern after the procedure. Pyeloplasty led to increased relative renal function in the short term from 36.7% ± 1.2% before surgery to 41.2% ± 0.91% in all patients (p <0.001). It remained stable at 43.2% ± 0.75% after puberty in all reviewed patients. Conclusions: To our knowledge our data show for the first time that successful pyeloplasty after the prenatal diagnosis of ureteropelvic junction obstruction is associated with improved renal function throughout puberty. References 1 : Does early detection of ureteropelvic junction obstruction improve surgical outcome in terms of renal function?. J Urol1999; 162: 1037. Link, Google Scholar 2 : Does delaying pyeloplasty affects renal function in children with a prenatal diagnosis of pelvi-ureteric junction obstruction?. BJU Int2002; 90: 72. Google Scholar 3 : Conservative treatment of uretero-pelvic junction obstruction in children with antenatal diagnosis of hydronephrosis: lessons learned after 16 years of follow up. Eur Urol2006; 49: 734. Google Scholar 4 : Unilateral ureteroplevic junction obstruction in children: long-term followup after unilateral pyeloplasty. J Urol2003; 170: 575. Link, Google Scholar 5 : The long-term results of Anderson-Hynes pyeloplasty. BJU Int2001; 87: 287. Google Scholar 6 : Long-term follow of pediatric dismembered pyeloplasty: how long is long enough?. J Urol2003; 169: 1809. Link, Google Scholar 7 : Improvement of renal split function in hydronephrosis with less than 10% function. Eur J Pediatr Surg2008; 18: 156. Google Scholar 8 : Does prenatal diagnosis influence the morbidity associated with left in situ nonfunctioning or poorly functioning renal moiety after endoscopic puncture of ureterocele?. J Urol2005; 173: 1349. Link, Google Scholar 9 : Ultrasound grading of hydronephrosis: introduction to the system used by Society for Fetal Urology. Pediatr Radiol1993; 23: 478. Google Scholar 10 : The “well tempered” diuretic renogram: a standard method to examine the asymptomatic neonate with hydronephrosis: A result from combined meetings of the Society for Fetal Urology and members of the Pediatric Nuclear Medicine Council—the Society of Nuclear Medicine. J Nucl Med1992; 33: 2047. Google Scholar 11 : Antenatal hydronephrosis as a predictor of postnatal outcome: a meta-analysis. Pediatrics2006; 118: 586. Google Scholar 12 : Unilateral ureteral obstruction in neonatal rats leads to renal insufficiency in adulthood. Kidney Int2000; 58: 1987. Google Scholar © 2009 by American Urological AssociationFiguresReferencesRelatedDetailsCited byHarraz A, Helmy T, Taha D, Shalaby I, Sarhan O, Dawaba M and Hafez A (2013) Changes in Differential Renal Function after Pyeloplasty in ChildrenJournal of Urology, VOL. 190, NO. 4S, (1468-1473), Online publication date: 1-Oct-2013.Barbosa J, Barayan G, Gridley C, Sanchez D, Passerotti C, Houck C and Nguyen H (2013) Parent and Patient Perceptions of Robotic vs Open Urological Surgery Scars in ChildrenJournal of Urology, VOL. 190, NO. 1, (244-250), Online publication date: 1-Jul-2013.Romao R, Farhat W, Pippi Salle J, Braga L, Figueroa V, Bägli D, Koyle M and Lorenzo A (2012) Early Postoperative Ultrasound After Open Pyeloplasty in Children with Prenatal Hydronephrosis Helps Identify Low Risk of Recurrent ObstructionJournal of Urology, VOL. 188, NO. 6, (2347-2353), Online publication date: 1-Dec-2012.Bandin F, Siwy J, Breuil B, Mischak H, Bascands J, Decramer S and Schanstra J (2012) Urinary Proteome Analysis at 5-Year Followup of Patients With Nonoperated Ureteropelvic Junction Obstruction Suggests Ongoing Kidney RemodelingJournal of Urology, VOL. 187, NO. 3, (1006-1011), Online publication date: 1-Mar-2012. Volume 182Issue 4SOctober 2009Page: 1845-1848 Advertisement Copyright & Permissions© 2009 by American Urological AssociationKeywordspubertyureterkidneyprenatal diagnosiskidney function testsMetricsAuthor Information Boris Chertin Department of Urology, Shaare Zedek Medical Center, Jerusalem, Faculty of Medical Science, Hebrew University, Jerusalem, Israel Department of Urology (Division of Pediatric Urology), Shaare Zedek Medical Center, Jerusalem, Faculty of Medical Science, Hebrew University, Jerusalem, Israel More articles by this author Avner Pollack Department of Urology, Shaare Zedek Medical Center, Jerusalem, Faculty of Medical Science, Hebrew University, Jerusalem, Israel Department of Urology (Division of Pediatric Urology), Shaare Zedek Medical Center, Jerusalem, Faculty of Medical Science, Hebrew University, Jerusalem, Israel More articles by this author Dmitry Koulikov Department of Urology, Shaare Zedek Medical Center, Jerusalem, Faculty of Medical Science, Hebrew University, Jerusalem, Israel More articles by this author Ron Rabinowitz Obstetric Ultrasound Unit, Shaare Zedek Medical Center, Jerusalem, Faculty of Medical Science, Hebrew University, Jerusalem, Israel More articles by this author Ori Shen Obstetric Ultrasound Unit, Shaare Zedek Medical Center, Jerusalem, Faculty of Medical Science, Hebrew University, Jerusalem, Israel More articles by this author Daniel Hain Department of Nuclear Medicine, Shaare Zedek Medical Center, Jerusalem, Faculty of Medical Science, Hebrew University, Jerusalem, Israel More articles by this author Irit Hadas-Halpren Department of Diagnostic Radiology, Shaare Zedek Medical Center, Jerusalem, Faculty of Medical Science, Hebrew University, Jerusalem, Israel More articles by this author Amicur Farkas Department of Urology, Shaare Zedek Medical Center, Jerusalem, Faculty of Medical Science, Hebrew University, Jerusalem, Israel Department of Urology (Division of Pediatric Urology), Shaare Zedek Medical Center, Jerusalem, Faculty of Medical Science, Hebrew University, Jerusalem, Israel More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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