Outcome of pyeloplasty in children

Background: hydronephrosis in children is a common congenital urologic problem with pelviureteric junction obstruction being its most common cause. this study was conducted to evaluate the outcome of pyeloplasty for congenital pelviureteric junction obstruction in children.methods: this study was conducted in department of paediatric surgery,quaid-e-azam medical college/bahawal victoria hospital,bahawalpur from july 2008 to december 2010. a total of 50 patients diagnosed on ultrasonography and intravenous urogram as having puj obstruction were included. patients with history of previous repair were excluded. both dismembered (anderson hynes) and non-dismembered (flap procedures) pyeloplasties were performed depending upon the size of pelvis and degree of dilatation. initial follow-up was after 1 week,then after 15 days and then monthly for 3 months. minimum follow-up period was 6 months and maximum 15 months. at three month,excretory urography was obtained to assess the function of that particular renal unit.results: lumbar pain and flank mass were the commonest presenting complaints. thirty-six (72%) patients were male. left sided obstruction was in 32 (64%) cases,right-sided in 15 (30%),and 3 (6%) cases were bilateral. common post-operative complications were urinoma formation and re-stenosis in two cases each. there was also no gross difference of outcome in pyeloplasty whether done with or without double-j (dj) stents. moreover,dismembered pyeloplasty resulted in better outcome.conclusions: open pyeloplasty is the gold standard treatment option for congenital pelviureteric junction obstruction. the use of dj stents is not necessary in every repair.