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ULTRASOUND AND RENAL SCINTYGRAPHY IN CHILDREN WITH URETEROPELVIC JUNCTION OBSTRUCTION TREATED BY LAPAROSCOPIC ASSISTED RETROPERITONEAL USING ONE TROCAR
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Abstract
Objective: To describe the characteristics of ultrasound and renal scintigraphy in patients who underwent surgery for hydronephrosis due to congenital pelvi-ureteral junction (PUJ) obstruction. Subjects and Methods: We retrospectively reviewed the medical records of 70 patients under 5 years old diagnosed with congenital hydronephrosis due to PUJ obstruction, who underwent surgery with laparoscopic retroperitoneal single trocar assistance from January 2011 to June 2013 at the Urology Department of the National Children’s Hospital. Information on age, gender, clinical symptoms, anterior-posterior diameter of the renal pelvis on ultrasound, and urinary excretion features on renal scintigraphy were recorded. Results: A total of 70 records met the study criteria. Of these, 65 were male (92.86%) and 5 were female (7.14%), with ages ranging from 1 month to 5 years (mean age: 22.9 ± 18.6 months). 100% of the patients underwent preoperative ultrasound to measure the anterior-posterior diameter of the renal pelvis, assess the degree of calyceal dilation, and evaluate renal parenchymal thickness. The mean preoperative renal pelvis size was 34.3 ± 8.1 mm (ranging from 25 mm to 50 mm). 56 out of 70 (80%) patients underwent preoperative renal scintigraphy. The mean renal function before surgery was 47.9 ± 9.8%. Of these 56 patients, 36 (64.3%) showed an accumulation-type excretion curve, while 20 (35.7%) had a slow excretion curve. No patients exhibited a normal excretion curve. There was a significant difference in renal function between patients with renal pelvis diameters above 35 mm and those below 35 mm (p<0.05). Conclusion: Ultrasound and renal scintigraphy are valuable diagnostic tools for assessing and determining the degree of urinary obstruction at the PUJ in children with congenital hydronephrosis.
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Keywords
Hydronephrosis, ureteropelvic junction obstruction, laparoscopic dismembered pyeloplasty
References
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