Hydronephrosis

Hydronephrosis

 

• PA
  Cornford, AMK Rickwood [ Alder Hey Children’s Hosp,
  Liverpool, England ]
  
  Functional
  Results of Pyeloplasty  in Patients with Ante-natally diagnosed Pelvi-Ureteric
  Junction Obstruction
  
  Br
  J Urol 81 : 152-155, 1998
  
   
  
  Method
  – 1984
  and 1995, 321 patients were referred with a
  diagnosis of antenatal hydronephrosis and were shown
  have PUJ obstruction. Pyeloplasty was performed if
  the relative renal function evaluated
  renographically before and at least 1 year after
  surgery.
  
   
  
  Results
  –  2
  patients had post operative urinary tract infection.
  From at total of 47 pyeloplasy . renographic
  reassessment showed no cases of continuing
  obstruction. Relative renal function was stabilized
  in patients who underwent early pyeloplasty.
  
    
  
  The
  mean differential function increased from 28.1%
  before surgery to 32.7% after surgery.
  
   
  
  Among
  patients who underwent pyeloplasty after a period of
  expectant management the mean relative function
  decreased from 44.8% initially to 30.5% before
  surgery. At postoperative reassessment there was a
  recovery of 37.5% indicating a statistically
  significant loss of function.
  
   
  
  Conclusion
  – Peloplasty failed to significantly improve
  function in patients born with PUJ obstruction and
  impaired renal function 
  perhaps because of cortical loss. Thus,
  although early pyeloplasty stabilizes function,
  expectant management must be vigilant to prevent a
  small but modest loss of renal function.
  
      

• CR
  Pal, JRD Tuson , DRM Lindsell, et al [ John
  Radcliffe Hosp, Oxford, England]
  
  The Role of Micturating Cystourethrography in Antenatally Detected Mild
  Hydronephrosis
  
  Pediatr
  Radiol 28: 152-155, 1998
  
      
  
  Conclusion
  -
  All  infants
  with mild hydronephrosis should undergo MCUG. This
  assessment need not be delayed until 3 months,
  rather, it would be performed after a 6 week US
  scan.