Long-term results of pyeloplasty in poorly functioning kidneys in the pediatric age group

Objective: To determine the efficacy and long-term outcome of pyeloplasty in poorly functioning kidneys in the pediatric age group. Method: Retrospective data analysis was performed on patients who underwent pyeloplasty in 2000-2008. The parameter analyzed was postoperative outcome. Success was defined on the basis of either improvement in symptoms or better drainage on postoperative Tc-99m DTPA renography done after 3 months and yearly thereafter. Results: A total of 39 patients with a mean age of 8.6 years (4 months to 13 years), and male to female ratio of 3: 1, with poor function on isotope renogram (<30%) were included in the study. Left to right side ratio was 1.3:1. Dismembered pyeloplasty was done in all patients. Laparoscopic pyeloplasty was done in 27 (66.7%) and open in 12 (33.3%) patients. Follow-up renograms were available for 35 patients: 31 showed improvement in drainage and no further deterioration in renal function and 4 showed an obstructed pattern; of these, two patients had significant deterioration in split function and the other two underwent redo pyeloplasty by open technique. At a mean follow up of 41.6 months (8-75), overall success rate was 90%. Conclusion: Pyeloplasty gives good intermediate-term results in poorly functioning kidneys in the pediatric age group. (C) 2011 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.