|
KMID : 1218220090010020073
|
|
Korean Journal of Pediatric Urology
2009 Volume.1 No. 2 p.73 ~ p.80
|
|
|
Congenital Ureteropelvic Junction Obstruction: Early Pyeloplasty and Conservative Treatment
|
|
Park Chang-Soo
Lee Sang-Don
|
|
|
Abstract
|
|
|
|
Ureteropelvic junction obstruction (UPJO) is a principal cause of renal damage in infant and young children and can lead to early, permanent loss of renal function. For those with suspected UPJO, debate is ongoing regarding the optimal management. Historically, most children with high-grade hydronephrosis were treated surgically. Few debate that a fully obstructed kidney should be operated on immediately and that failure to do so can result in loss of organ function. Recently, studies have indicated that conservative management is appropriate for children who might not have complete UPJO. At present, however, no single diagnostic method exists that will differentiate a fully obstructed kidney from a kidney that is physiologically obstructed but that could resolve spontaneously with conservative management. Thus, the serial ultrasonography findings, clinical symptoms and differential renal function on nuclear renal scan are better indicators than single method alone for determining whether pyeloplasty is indicated. If surgical indication is ambiguous, several studies show that early and delayed pyeloplasty are alike in restoration of renal function. Therefore, even if open pyeloplasty is inevitable in some infants or younger children, it is desirable to select those who can wait for definitive management until 6 months later. Furthermore, laparoscopic pyeloplasty may be performed on children at leat one year of age.
|
|
|
KEYWORD
|
|
|
Ureteral obstruction, Hydronephrosis, Management
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|
|