PREDICTORS OF SURGICAL OUTCOME FOLLOWING PYELOPLASTY IN CHILDREN WITH URETEROPELVIC JUNCTION OBSTRUCTION: A CASE SERIES

Abstract

Background: Ureteropelvic junction obstruction (UPJO) is a common cause of upper urinary tract obstruction in children and may present with antenatally detected hydronephrosis, urinary tract infection, abdominal symptoms, or impaired renal function. Pyeloplasty remains an established surgical treatment for relieving obstruction and preserving renal function. Case Series: This case series describes the clinical experience of a tertiary-care centre in managing 11 children with UPJO who underwent pyeloplasty. The individual cases demonstrated a varied spectrum of presentation and anatomical findings, including antenatal detection, unilateral hydronephrosis, severe renal pelvic dilatation, cortical thinning, reduced differential renal function, lower-polar crossing vessels, and duplex renal anatomy with lower-moiety obstruction. Laparoscopic Anderson–Hynes dismembered pyeloplasty was the predominant surgical procedure, while open pyeloplasty was performed in selected cases. Postoperative clinical and radiological follow-up was undertaken to assess resolution of obstruction and identify complications or recurrence. Most children had an uncomplicated postoperative course and satisfactory follow-up findings. One child developed recurrent obstruction following primary pyeloplasty and subsequently underwent redo pyeloplasty with repeat stenting. Conclusion: This case series reflects the varied clinical and anatomical presentations of paediatric UPJO encountered in a tertiary-care setting. Pyeloplasty provided satisfactory outcomes in the majority of cases. Careful preoperative assessment, appropriate selection of surgical technique, recognition of anatomical variations, and structured postoperative follow-up are important for successful management of children with UPJO.