Surgical Management of Ureteropelvic Junction Obstruction in Children.
- Author:
Hyeok Jun SEO
1
;
Sung Kwang CHUNG
;
Yoon Kyu PARK
Author Information
1. Kyungpook National University, School of Medicine, Taegu, Korea.
- Publication Type:Original Article
- Keywords:
children;
ureteropelvic junction obstruction;
pyeloplasty
- MeSH:
Abdominal Pain;
Child*;
Hematuria;
Humans;
Infant;
Nephrectomy;
Postoperative Complications;
Stents;
Ureter;
Urinary Tract Infections;
Urography;
Wound Infection
- From:Korean Journal of Urology
1997;38(11):1190-1195
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
From January 1988 to January 1996, 42 infants and children (44 renal units) had undergone surgical management to correct ureteropelvic junction obstruction. Median patient age was 8.5 years (range from 2 months to 17 years) and 11 patients were less than 1 year old at operation. Of 44 renal units surgically managed, 30 were on the left side and 10 were right side. 2 patients had undergone bilateral surgical management. Presenting symptoms were febrile urinary tract infection in 14 cases, abdominal pain in 14 cases, abdominal mass in 5 cases, gross hematuria in 3 cases and 3 cases were detected prenatally. We used imaging antegrade pyelography (AGP) in 15 cases, additional retrograde pyelography (RGP) in 12 cases and both AGP and RGP were performed in 1 case. To correct ureteropelvic junction obstruction, we performed dismembered pyeloplasty in 33 renal units, ureterolysis in 2 renal units, ureterocalycostomy in 1 renal unit, endopyelotomy in 1 renal unit and nephrectomy in 7 renal units. To diverge the urinary flow, we used nephrostomy in 19 renal units, ureteral stenting in 6 renal units and both nephrostomy and ureteral stenting were used in 10 renal units. As postoperative complications, restenosis was developed in 5 renal units, delayed open in 5 renal units, urinary tract infection in 2 renal units and wound infection, prolonged urine leakage, ureteral stone in each 1 renal unit. Postoperative success rate in followed-up patients, who had undergone pyeloplasty, was 91.6%. The success rate in children, who was less than 1 year old, was 100% and in children, who was more than 1 year old, was 88.4%. Finally we suggest that the surgical correction is safe and proper method for ureteropelvic junction obstruction in children. Additionally early operation of ureteropelvic junction obstruction is recommendable.
