Outcome analysis of pyeloplasty in infants

The study examined the outcome of pyeloplasties done for decompensated uret eropelvic junction (UPJ) obstruction in infancy over a 13-year period. In a retrospective study, 186 children who underwent pyeloplasty in infancy wer e analysed with particular emphasis on the pre- and postoperative findings of I-123 hippuran scintigraphy/diuretic renograms. The pre- and postoperati ve management is outlined in detail. The 186 patients underwent a total of 203 pyeloplasties during the period from January 1983 to 31 December 1996. Three children died; one required a nephrectomy. The postoperative scintigr apic results of 156 children (85%) done about 12 months after surgery were available for evaluation: 101 (64%) showed stable renal function and 43 (27 %) revealed more than 5% improvement of renal function. In 12 cases (7%) re nal function deteriorated after pyeloplasty by more than 5% compared to the preoperative scintigram. It is concluded that pyeloplasty in infants is a low-risk procedure. The encouraging results of this series support early co rrection of UPJ obstruction.