UroToday - A study by Dr. Marco Castagnetti, et al. evaluated scintigraphic renography after unilateral pyeloplasty to evaluate postoperative function in the pediatric population. They systematically reviewed previous reports in order to determine the functional outcomes, after pyeloplasty, in children with UPJ obstructions on one side. They evaluated Medline, EMBase and Web Science articles in English published from1966 to 2007. Thirty-six studies were eventually selected for review.

They found that postoperative function exhibited a wide variability. It appeared that patients who presented symptomatic had a greater chance of functional improvement after surgery than the asymptomatic group. Intuitively, they also found that those who presented with impaired preoperative function had less of a recovery than those with moderately impaired function. They found no correlation with improvement in function when compared to age of surgery, preoperative ultrasound findings or the excretory phase on renal scintigraphy. They also found that even in patients with delayed surgery, over 97% had preserved function after surgery.

The group concluded from their study that patients with moderately impaired preoperative function and those diagnosed postnatally (with the presentation of symptoms) were more likely to have functional improvement after surgery.

Castagnetti M, Novara G, Beniamin F, Vezzú B, Rigamonti W, Artibani W
BJU Int. 2008 Sep;102(7):862-8
doi:10.1111/j.1464-410X.2008.07597.x

UroToday Medical Editor Pasquale Casale, MD

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