Ten chidren were selected out of 21 cases diagnosed as ureteropelvic junction obstruction between March, 989 and March, 1992j. The children were evaluated quantitatively using the renal cortical labeling agent, 99m technetium dimercaptosuccinic
acid
(99mTc-DMSA), before and recovery were investigated. The children ranged from 15 months to 13 years old (average 6.8 years) and consisted of 8 boys and 2 girls. The obstruction was on the left in 7 cases and the right in 3. Skymptoms on admission
included pain in 5 cases, abdominal mass in 3 cases, and fever and chill in 2 The subiects divided into two groups. The first group consisted of children who did not have complications or other coexisting diseases, while the second consisted of
who
had
pyonephrosis or vesicoureteral reflux. All patients underwont dismembered pyeloplasty and the resufslts swere satisfactory inall.
1. The preoperative differential renal function by 99mTc-DMSa renal scintigraphy ranged from 0.5% to 46.0% (mean 19.1%) and increased to 3.5% to 46.9% (mean 28.8%) postoperatively.
2. In five of the seven cases with uncomplicated ureteropelvic junction obstruction, differential renal function increased more than 10% following pyeloplasty. In the two other cases which showed presserved renal function of up to 40%
preoperatively,
noticeable changes not observed.
3. In the three cases w iths complicated ureteropelvic junction obstruction, (two cases associated with pyonephrosis and one case withs vesicou5reteral reflux) only slight increased differential renal function.
In conclusion, we suggest that severely obstructed kidneys in infants and children spare nephrectomy and encourage pyeloplasty, even in cases on non-visualization on excretory urography in hopes of improving relative renal function.
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