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Long‐term functional and morphological outcome after pyeloplasty for huge renal pelvis
Study Type – Therapy (case series) Level of Evidence 4 OBJECTIVE • To evaluate the functional and morphological outcome after open pyeloplasty for ureteropelvic junction obstruction (UPJO) with huge renal pelvis. PATIENTS AND METHODS • A retrospective review of all cases who underwent pyeloplasty fo...
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Published in: | BJU international 2011-03, Vol.107 (5), p.829-833 |
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Main Authors: | , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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Summary: | Study Type – Therapy (case series)
Level of Evidence 4
OBJECTIVE
• To evaluate the functional and morphological outcome after open pyeloplasty for ureteropelvic junction obstruction (UPJO) with huge renal pelvis.
PATIENTS AND METHODS
• A retrospective review of all cases who underwent pyeloplasty for huge renal pelvis was conducted.
• Records were evaluated with respect to age at presentation, preoperative imaging, surgical details and postoperative course. Patients were followed up regularly for both functional and morphological outcome.
• Success was defined as both symptomatic relief and radiographic resolution of obstruction at last follow‐up.
RESULTS
• Between 1998 and 2008, 526 cases of primary UPJO underwent open dismembered pyeloplasty at our centre.
• Of these patients, 41 (8%) had UPJO with huge renal pelvis.
• No perioperative complications were encountered in the study group. Mean (range) follow‐up was 34 (18–84) months and nine patients were lost to follow‐up. The overall success rate was 91%.
• Two patients underwent redo pyeloplasty, whereas secondary nephrectomy was necessary in one.
• Improvement of hydronephrosis was evident in all patients, except in three patients who underwent secondary procedures.
• However, persistent obstruction on diuretic renography was seen in most cases (65%).
CONCLUSIONS
• Open pyeloplasty for huge pelvis UPJO is feasible with a high success rate.
• Varying degrees of hydronephrosis and radiological obstruction after pyeloplasty are not uncommon.
• Nephrectomy is rarely indicated in cases with severely deteriorated renal function. |
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ISSN: | 1464-4096 1464-410X |
DOI: | 10.1111/j.1464-410X.2010.09566.x |