IS RETROGRADE URETEROPYELOGRAPHY PRIOR TO PYELOPLASTY NECESSARY IN CHILDREN

For routine evaluation of ureteropelvic junction obstruction in childr en, sonography, voiding cystogram, IV pyelogram and a renal scan in co mbination with administration of furosemide are available. Furthermore , often preoperative antegrade or retrograde ureteropyelography is per formed. However, the significance of retrograde ureteropyelography in the world literature remains controversial. Therefore, we reviewed the records of 41 children who underwent a pyeloplasty in our department. In 9 children the ureter was visualized by IV pyelogram, voiding cyst ogram or antegrade ureteropyelography; a retrograde examination of the ureter was performed in 21 children before pyeloplasty in the OR. In 11 children the ureter was not visualized preoperatively. Retrograde u reterography neither gave additional information in any patient nor di d it change the operative technique. In the children where the ureter was not visualized preoperatively, no ureteric abnormality was found i n association with ureteropelvic junction obstruction. Hence, we concl ude that retrograde ureteropyelography before pyeloplasty in children is not necessary, provided that sonography does not show ureteral dila tation.