THE ROLE OF ULTRASOUND IN THE FOLLOW-UP OF POSTOPERATIVE CHANGES AFTER PYELOPLASTY

Background. Pyeloplasty is an established treatment for pelviureteric junction (PUJ) obstruction. The postoperative change in the size of th e renal pelvis and the kidney parenchyma are variable. Objective. To d ocument the changes in renal pelvic size and renal parenchymal thickne ss following pyeloplasty and to establish that improvement of both par ameters are good markers for improved urine flow. Materials and method s. A group of 267 newborns and young infants with suspected PUJ obstru ction were investigated by ultrasound. Pyeloplasty was performed on 10 2 babies, and 165 patients were followed conservatively. Postoperative ultrasonography at 6 and 12 months was available in 88 patients. Resu lts. One year after surgery, the renal pelvis was smaller in 76 % of t he cases. The renal parenchyma was normal or had increased in 92 % of cases. Conclusion. Resolution of hydronephrosis after surgery is relat ively slow, but renal parenchymal growth is rapid. Mild postoperative pelvic dilatation is frequent and does not indicate continued obstruct ion.