Optimal Timing of Surgery of Hydronephrosis Due to
Ureteropelvic Junction Obstruction in Neonates and Infants

Ha, Seung Ju; Jung, Ji Hyun; Lee, Byeong Seon; Kim, Kun Seok; Moon, Dae Hyuk; Park, Young Seo

Original Article

Journal of the Korean Pediatric Society 2002;45(2):223-231.
Published online February 15, 2002.

Optimal Timing of Surgery of Hydronephrosis Due to Ureteropelvic Junction Obstruction in Neonates and Infants

Seung Ju Ha¹, Ji Hyun Jung¹, Byeong Seon Lee¹, Kun Seok Kim², Dae Hyuk Moon³, Young Seo Park¹

¹Department of Pediatrics, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.
²Department of Urology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.
³Department of Nuclear Medicine, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.

영유아의 신우 요관 이행부 폐쇄로 인한 수신증의 적절한 수술시기

하승주^¹^, 정지현^¹^, 이병선^¹^, 김건석^²^, 문대혁^³^, 박영서^¹

^¹울산대학교 의과대학 소아과학교실
^²울산대학교 의과대학 비뇨기과학교실
^³울산대학교 의과대학 핵의학과학교실

Correspondence:
Young Seo Park, Email: yspark@amc.seoul.co.kr

Abstract

Purpose
: We review our experience with pyeloplasty for unilateral ureteropelvic junction obstruction of moderate to severe hydronephrosis observed by prenatal ultrasonography to assess the appropriate timing of operation for recovery of renal function and obstruction.
Methods
: We retrospectively reviewed the records of the total 28 patients who underwent pyeloplasty between 1995 and 2001 at Asan Medical Center. We compared pre and postoperative differentials in renal function and diuretic renogram as measured by technetium-99m-mercaptoacetyl- triglycerine scan and the degree of hydronephrosis by renal ultrasonography.
Results
: In all 28 patients postoperative follow-up renal ultrasonography revealed significant improvement in hydronephrosis. In 10 poorly functioning hydronephrotic kidneys in which relative renal function function was less than 35%, renal function was improved postoperatively in 3 cases, but not improved in 7 cases. In all 28 patients postoperative follow-up diuretic renogram revealed significant improvement.
Conclusion
: We believe that the early pyeloplasty should be considered when ultrasonography and diuretic renography suggest obstruction because renal function does not improve significantly after pyeloplasty over preoperative value.

Key Words: Hydronephrosis, Ureteropelvic junction obstruction, Technetium-99m-mercaptoacetyl- triglycerine scan, Renal ultrasonography, Pyeloplasty