Dismembered Pyeloplasty for Ureteropelvic Junction Obstruction in Children

Hwang, Hyon Woo; Woo, Young Nam

Abstract

Ureteropelvic junction obstruction is one of the most common problems requiring surgical correction in children. Glomerular development, which continues at birth, may interfered with by obstruction. So the recognition and correction of ureteropelvic Junction obstruction at this early age are important. Fortunately, to date, the widespread use of maternal ultrasound has led to an increase in the detection of fetal obstructive uropathy. The operative technique varied according to the nature and severity of the abnormality, but the dismembered pyeloplasty that resect the adynamic segment completely is favored and very successful. We reported 17 cases underwent dismembered pyeloplasty in children due to severe hydronephrosis (over Grade IV) secondary to UPJ stricture, and obtained satisfactory results. Nephrostomy drainage of the kidney was used in l3 cases, and duration was within 2 weeks in most cases. Ureteral stent was used only in 4 cases associated with severe infection or repeated pyeloplasty. In 13 cases followed up over 3 months (Mean: 16 months), the good result was in 11 cases (84.6%) and fair in 2 cases(l5.4%).