Clinical and radiographic outcomes following salvage intervention for ureteropelvic junction obstruction
Int. braz. j. urol
;
47(6): 1209-1218, Nov.-Dec. 2021. tab, graf
Article
Dans Anglais
| LILACS
| ID: biblio-1340040
ABSTRACT
ABSTRACT Purpose:
We aimed to assess failure rates of salvage interventions and changes in split kidney function (SKF) following failed primary repair of ureteropelvic junction obstruction (UPJO). Materials andMethods:
A retrospective review of adult patients at an academic medical center who underwent salvage intervention following primary treatment for UPJO was performed. Symptomatic failure was defined as significant flank pain. Radiographic failure was defined as no improvement in drainage or a decrease in SKF by ≥7%. Overall failure, the primary outcome, was defined as symptomatic failure, radiographic failure, or both.Results:
Between 2008-2017, 34 patients (median age 38 years, 50% men) met study criteria. UPJO management was primary pyeloplasty/secondary endopyelotomy for 21/34 (62%), primary pyeloplasty/secondary pyeloplasty for 6/34 (18%), and primary endopyelotomy/secondary pyeloplasty for 7/34 (21%). Median follow-up was 3.3 years following secondary intervention. Patients undergoing primary pyeloplasty/secondary endopyelotomy had significantly higher overall failure than those undergoing primary pyeloplasty/secondary pyeloplasty (16/21 [76%] vs. 1/6 [17%], p=0.015). Among patients undergoing secondary endopyelotomy, presence of a stricture on retrograde pyelogram, stricture length, and SKF were not associated with symptomatic, radiographic, or overall failure. Serial renography was performed for 28/34 (82%) patients and 2/28 (7%) had a significant decline in SKF.Conclusions:
Following failed primary pyeloplasty, secondary endopyelotomy had a greater overall failure rate than secondary pyeloplasty. No radiographic features assessed were associated with secondary endopyelotomy failure. Secondary intervention overall failure rates were higher than reported in the literature. Unique to this study, serial renography demonstrated that significant functional loss was overall infrequent.
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Obstruction urétérale
/
Laparoscopie
Type d'étude:
Étude observationnelle
/
Facteurs de risque
Limites du sujet:
Adulte
/
Femelle
/
Humains
/
Mâle
langue:
Anglais
Texte intégral:
Int. braz. j. urol
Thème du journal:
Urologie
Année:
2021
Type:
Article
Pays d'affiliation:
États-Unis d'Amérique
Institution/Pays d'affiliation:
University of Texas Southwestern Medical Center/US
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