Renal ultrasound changes after pyeloplasty in children with ureteropelvic junction obstruction: Long-term outcome in 47 renal units

Christopher Amling, Sara M. O'Hara, John S. Wiener, Cameron S. Schaeffer, Lowell R. King

Research output: Contribution to journalArticle

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Abstract

Purpose: We evaluated the use of renal ultrasound for monitoring pyelocaliectasis after pyeloplasty in children. Materials and Methods: Changes in pyelocaliceal dilatation following pyeloplasty were assessed by serial ultrasound. Of 104 children 0 to 12 years old who underwent pyeloplasty between 1982 and 1992, 44 (47 renal units) were monitored with serial ultrasound for at least 2 years (range 2 to 9, mean 3.8). Patient ages at pyeloplasty were 0 to 3 months (17), 4 to 12 months (8), 1 to 6 years (13) and 7 to 12 years (6). Preoperative and postoperative ultrasound was reviewed by a single pediatric radiologist blinded to the date of surgery. The degree of pyelocaliectasis was graded as 0 to 4 according to the classification of the Society for Fetal Urology. Results: Preoperative ultrasound revealed grade 4 pyelocaliectasis in 26 kidneys (55%) and grade 3 disease in 21 (45%). Grade was the same or worse 1 month after pyeloplasty in the majority of kidneys (92%) studied at this interval. Of the 47 renal units assessed 43 (91%) showed improvement in pyelocaliectasis during postoperative followup. Only 38% of the kidneys improved during the first 6 months of followup, while 81% were improved 2 years postoperatively. Improvement to grade O or i dilatation occurred in only 9 kidneys (19%). The rate of resolution of pyelocaliectasis was not related to preoperative grade or patient age at pyeloplasty. Conclusions: Improvement on renal ultrasound after pyeloplasty appears to be gradual. Less than half of the patients had improvement in the initial 6 months after pyeloplasty and pyelocaliectasis rarely resolved completely. While renal ultrasound can provide an accurate and cost-effective means of monitoring children on a long-term basis after pyeloplasty, sonographic evaluation in the early postoperative period commonly shows increased or unchanged pyelocaliectasis.

Original languageEnglish (US)
Pages (from-to)2020-2024
Number of pages5
JournalJournal of Urology
Volume156
Issue number6
DOIs
StatePublished - Dec 1996
Externally publishedYes

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Kidney
Dilatation
Urology
Postoperative Period
Pediatrics
Costs and Cost Analysis

Keywords

  • dilatation, pathologic
  • kidney
  • ultrasonography

ASJC Scopus subject areas

  • Urology

Cite this

Renal ultrasound changes after pyeloplasty in children with ureteropelvic junction obstruction : Long-term outcome in 47 renal units. / Amling, Christopher; O'Hara, Sara M.; Wiener, John S.; Schaeffer, Cameron S.; King, Lowell R.

In: Journal of Urology, Vol. 156, No. 6, 12.1996, p. 2020-2024.

Research output: Contribution to journalArticle

Amling, Christopher ; O'Hara, Sara M. ; Wiener, John S. ; Schaeffer, Cameron S. ; King, Lowell R. / Renal ultrasound changes after pyeloplasty in children with ureteropelvic junction obstruction : Long-term outcome in 47 renal units. In: Journal of Urology. 1996 ; Vol. 156, No. 6. pp. 2020-2024.
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title = "Renal ultrasound changes after pyeloplasty in children with ureteropelvic junction obstruction: Long-term outcome in 47 renal units",
abstract = "Purpose: We evaluated the use of renal ultrasound for monitoring pyelocaliectasis after pyeloplasty in children. Materials and Methods: Changes in pyelocaliceal dilatation following pyeloplasty were assessed by serial ultrasound. Of 104 children 0 to 12 years old who underwent pyeloplasty between 1982 and 1992, 44 (47 renal units) were monitored with serial ultrasound for at least 2 years (range 2 to 9, mean 3.8). Patient ages at pyeloplasty were 0 to 3 months (17), 4 to 12 months (8), 1 to 6 years (13) and 7 to 12 years (6). Preoperative and postoperative ultrasound was reviewed by a single pediatric radiologist blinded to the date of surgery. The degree of pyelocaliectasis was graded as 0 to 4 according to the classification of the Society for Fetal Urology. Results: Preoperative ultrasound revealed grade 4 pyelocaliectasis in 26 kidneys (55{\%}) and grade 3 disease in 21 (45{\%}). Grade was the same or worse 1 month after pyeloplasty in the majority of kidneys (92{\%}) studied at this interval. Of the 47 renal units assessed 43 (91{\%}) showed improvement in pyelocaliectasis during postoperative followup. Only 38{\%} of the kidneys improved during the first 6 months of followup, while 81{\%} were improved 2 years postoperatively. Improvement to grade O or i dilatation occurred in only 9 kidneys (19{\%}). The rate of resolution of pyelocaliectasis was not related to preoperative grade or patient age at pyeloplasty. Conclusions: Improvement on renal ultrasound after pyeloplasty appears to be gradual. Less than half of the patients had improvement in the initial 6 months after pyeloplasty and pyelocaliectasis rarely resolved completely. While renal ultrasound can provide an accurate and cost-effective means of monitoring children on a long-term basis after pyeloplasty, sonographic evaluation in the early postoperative period commonly shows increased or unchanged pyelocaliectasis.",
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AU - Schaeffer, Cameron S.

AU - King, Lowell R.

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N2 - Purpose: We evaluated the use of renal ultrasound for monitoring pyelocaliectasis after pyeloplasty in children. Materials and Methods: Changes in pyelocaliceal dilatation following pyeloplasty were assessed by serial ultrasound. Of 104 children 0 to 12 years old who underwent pyeloplasty between 1982 and 1992, 44 (47 renal units) were monitored with serial ultrasound for at least 2 years (range 2 to 9, mean 3.8). Patient ages at pyeloplasty were 0 to 3 months (17), 4 to 12 months (8), 1 to 6 years (13) and 7 to 12 years (6). Preoperative and postoperative ultrasound was reviewed by a single pediatric radiologist blinded to the date of surgery. The degree of pyelocaliectasis was graded as 0 to 4 according to the classification of the Society for Fetal Urology. Results: Preoperative ultrasound revealed grade 4 pyelocaliectasis in 26 kidneys (55%) and grade 3 disease in 21 (45%). Grade was the same or worse 1 month after pyeloplasty in the majority of kidneys (92%) studied at this interval. Of the 47 renal units assessed 43 (91%) showed improvement in pyelocaliectasis during postoperative followup. Only 38% of the kidneys improved during the first 6 months of followup, while 81% were improved 2 years postoperatively. Improvement to grade O or i dilatation occurred in only 9 kidneys (19%). The rate of resolution of pyelocaliectasis was not related to preoperative grade or patient age at pyeloplasty. Conclusions: Improvement on renal ultrasound after pyeloplasty appears to be gradual. Less than half of the patients had improvement in the initial 6 months after pyeloplasty and pyelocaliectasis rarely resolved completely. While renal ultrasound can provide an accurate and cost-effective means of monitoring children on a long-term basis after pyeloplasty, sonographic evaluation in the early postoperative period commonly shows increased or unchanged pyelocaliectasis.

AB - Purpose: We evaluated the use of renal ultrasound for monitoring pyelocaliectasis after pyeloplasty in children. Materials and Methods: Changes in pyelocaliceal dilatation following pyeloplasty were assessed by serial ultrasound. Of 104 children 0 to 12 years old who underwent pyeloplasty between 1982 and 1992, 44 (47 renal units) were monitored with serial ultrasound for at least 2 years (range 2 to 9, mean 3.8). Patient ages at pyeloplasty were 0 to 3 months (17), 4 to 12 months (8), 1 to 6 years (13) and 7 to 12 years (6). Preoperative and postoperative ultrasound was reviewed by a single pediatric radiologist blinded to the date of surgery. The degree of pyelocaliectasis was graded as 0 to 4 according to the classification of the Society for Fetal Urology. Results: Preoperative ultrasound revealed grade 4 pyelocaliectasis in 26 kidneys (55%) and grade 3 disease in 21 (45%). Grade was the same or worse 1 month after pyeloplasty in the majority of kidneys (92%) studied at this interval. Of the 47 renal units assessed 43 (91%) showed improvement in pyelocaliectasis during postoperative followup. Only 38% of the kidneys improved during the first 6 months of followup, while 81% were improved 2 years postoperatively. Improvement to grade O or i dilatation occurred in only 9 kidneys (19%). The rate of resolution of pyelocaliectasis was not related to preoperative grade or patient age at pyeloplasty. Conclusions: Improvement on renal ultrasound after pyeloplasty appears to be gradual. Less than half of the patients had improvement in the initial 6 months after pyeloplasty and pyelocaliectasis rarely resolved completely. While renal ultrasound can provide an accurate and cost-effective means of monitoring children on a long-term basis after pyeloplasty, sonographic evaluation in the early postoperative period commonly shows increased or unchanged pyelocaliectasis.

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