Mp24-06 Multicentre Study Regarding the Outcomes of Pyeloplasty and the Role of Follow up Imaging.
Year: 2017
Type: article
Abstract: You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Ureter (including Pyeloplasty) and Bladder Reconstruction (including fistula), Augmentation, Substitution, Diversion I1 Apr 2017MP24-06 MULTICENTRE STUDY REGARDING THE OUTCOMES OF PYELOPLASTY AND THE ROLE OF FOLLOW UP IMAGING. Marcelino Yazbek Hanna, Muhammad Elmussareh, Conor Devlin, Peter Smith, Ata Jaffer, Catriona Shenton, Naeem Desai, Richard Napier-Hemy, Anthony Browning, Andrew Myatt, and Bachar Zelhof Marcelino Yazbek HannaMarcelino Yazbek Hanna More articles by this author , Muhammad ElmussarehMuhammad Elmussareh More articles by this author , Conor DevlinConor Devlin More articles by this author , Peter SmithPeter Smith More articles by this author , Ata JafferAta Jaffer More articles by this author , Catriona ShentonCatriona Shenton More articles by this author , Naeem DesaiNaeem Desai More articles by this author , Richard Napier-HemyRichard Napier-Hemy More articles by this author , Anthony BrowningAnthony Browning More articles by this author , Andrew MyattAndrew Myatt More articles by this author , and Bachar ZelhofBachar Zelhof More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.3300AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Our aims were to assess the impact of waiting times on the split renal function after pyeloplasty and to determine the value of repeated MAG3 renograms after the procedure. We also compared the outcomes of pyeloplasty in those with split function >30% compared to those with poorly functioning kidney (split function ≤30%) METHODS Retrospective analysis of all cases that underwent primary pyeloplasty in four centres in the UK from 2008 to 2015. We excluded those < 16 years old, single kidney, bilateral UPJO and other congenital renal abnormalities. We also excluded patients that did not have FU imaging. A change of >5% split function on renogram was considered significant. Logistic regression analysis was used to determine the impact of waiting times on split renal function after pyeloplasty RESULTS 175 pts were included. The mean age was 41.2 years with a mean length of FU of 573 days. The mean pre-op split renal function (available in 161 cases) was 39.4% (SD 10.5). 35 pts had split function ≤30%. The mean waiting time from presentation to operation was 207 days (SD 277). The mean interval between pyeloplasty and 1st post-op renogram was 118 days (SD 73). The second post-op renogram was performed at a mean interval of 355 days (SD 193) following the 1st scan 89 pts had split function documented in one pre-op and two post-op renograms. Seventy-two cases (81%) showed stable or improved function on their first post-op renogram (58 stable, 14 improved) and the second post-op renogram showed renal function remained stable or improved in 68 (95%). In the remaining 4 pts, the split function only marginally deteriorated (average reduction of -7%). Of the 17 cases with worsening renal function on the 1st post-op renogram, the split function continued to deteriorate in only 2 cases. Both of which remained obstructed on the both 1st and 2nd post-op renograms. Pts that had worsening split function post-op had a longer waiting time for their procedure (the majority of those that waited over 200 days had poor functional outcomes, p= 0.01) Pain was the most common presenting symptom (80% of cases). 79.2% of these pts had improved symptoms post-op. Those with split function of ≤30% showed higher levels of pain post op (26.7%) compared to those with better function (20.8%) but this was not statistically significant (p=0.6) CONCLUSIONS Longer waiting times from presentation to definitive treatment appear to have a significant negative impact on split renal function post-pyeloplasty. The majority of patients received functional and symptomatic improvement post-pyeloplasty but there was no significant difference in outcome between those with split renal function of ≤30% compared those with better renal function. Those with favourable results on the 1st post-operative renogram (no obstruction with stable or improved function), may not require further imaging © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e304 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Marcelino Yazbek Hanna More articles by this author Muhammad Elmussareh More articles by this author Conor Devlin More articles by this author Peter Smith More articles by this author Ata Jaffer More articles by this author Catriona Shenton More articles by this author Naeem Desai More articles by this author Richard Napier-Hemy More articles by this author Anthony Browning More articles by this author Andrew Myatt More articles by this author Bachar Zelhof More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Source: The Journal of Urology
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2604110220