Wei Jia,Wu Dehua,Tao Chang,et al.Clinical feature analysis of acute symptomatic hydronephrosis in children with ureteropelvic junction obstruction.[J].Journal of Clinical Pediatric Surgery,,17():419-424.
Clinical feature analysis of acute symptomatic hydronephrosis in children with ureteropelvic junction obstruction.
Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R]
volume:
第17卷
Number:
2018 06
Page:
419-424
Column:
专题讨论
Date of publication:
2018-06-28
- Keywords:
- Hydronephrosis; Diagnosis; Therapy; Surgical Procedures; Operative; Child
- Document code:
- A
- Abstract:
- ObjectiveTo explore the clinical features of acute symptomatic hydronephrosis due to ureteropelvic junction obstruction (UPJO) in children and compare the characteristics between progressive hydronephrosis and intermittent hydronephrosis.MethodsThe clinical data of children with acute symptomatic hydronephrosis due to UPJO were retrospectively analyzed from January 2013 to December 2017.According to multiple preoperative urological ultrasonographies,they were divided into progressive hydronephrosis group and intermittent hydronephrosis group.The characteristics and outcomes of two groups were analyzed.ResultsAmong a total of 92 cases,there were 83 boys and 9 girls.The affected sides were left (n=72),right (n=19) and bilateral (n=1).The average followup period was 43.2 (4-60) months.The fluctuation range of anteroposterior diameter of renal pelvis in the progressive group was significantly higher than that in the intermittent group (t=3.36,P=0.02).Renal function of affected side was significantly lower in the progressive group than that the in intermittent group (36.1%±13.7% vs.43.6%±6.5%,t=2.25,P=0.03).Among 89 patients undergoing pyeloplasty,5 cases had renal vessels moved behind ureteropelvic junction.Two patients underwent urethroplasty for inferior vena cava while another 1 case underwent nephrectomy with renal function of impaired side below 10% due to massive hydronephrosis.The incidence of UPJO was significantly higher in the progressive hydronephrosis group than that in the intermittent hydronephrosis group (P=0.03).The length of ureteropelvic junction stenosis was significantly shorter in progressive hydronephrosis group than that in intermittent hydronephrosis group (1.66±0.62 vs.2.03±0.69 cm,t=2.24,P=0.03).ConclusionThe major clinical characteristics of acute symptomatic hydronephrosis in children are recurrent flank pains and spontaneous remission.Those with progressive or intermittent hydronephrosis require regular ultrasonographic examinations to avoid delayed timing of surgery.
Last Update:
2018-06-26