Ultrasonographic Stabilization In Hydronephrosis: Key Determinant Of The Length Of Follow-Up After Pyeloplasty

You have accessJournal of UrologyPediatric Urology II (MP44)1 Sep 2021MP44-05 ULTRASONOGRAPHIC STABILIZATION IN HYDRONEPHROSIS: KEY DETERMINANT OF THE LENGTH OF FOLLOW-UP AFTER PYELOPLASTY Maria C. Suarez, Isabella Cabrera, Daniel E. Nassau, Ruben Blachman-Braun, Justin Achua, David Valancy, Christopher Olson, Christian Guevara, Raquel Quintanilla, Alireza Alam, Andrew Labbie, Rafael Gosalbez, and Miguel A. Castellan Maria C. SuarezMaria C. Suarez More articles by this author , Isabella CabreraIsabella Cabrera More articles by this author , Daniel E. NassauDaniel E. Nassau More articles by this author , Ruben Blachman-BraunRuben Blachman-Braun More articles by this author , Justin AchuaJustin Achua More articles by this author , David ValancyDavid Valancy More articles by this author , Christopher OlsonChristopher Olson More articles by this author , Christian GuevaraChristian Guevara More articles by this author , Raquel QuintanillaRaquel Quintanilla More articles by this author , Alireza AlamAlireza Alam More articles by this author , Andrew LabbieAndrew Labbie More articles by this author , Rafael GosalbezRafael Gosalbez More articles by this author , and Miguel A. CastellanMiguel A. Castellan More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002065.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Although pediatric pyeloplasty is among the most common surgeries performed in urology, there is lacking consensus on the optimal length of follow-up after the procedure. To answer this controversial question, we aimed to determine the average time to hydronephrosis stabilization on ultrasound (US) after pyeloplasty and analyze variables that may impact this outcome. METHODS: Retrospective chart review of patients <21 years of age who underwent pyeloplasty from 2012 to 2020. Patients were excluded if pre- and postoperative US were not available. US stabilization was defined as 2 consecutive US, with a minimum of 1 month apart, that showed the same degree of hydronephrosis according to the Society of Fetal Urology (SFU) classification. Clinical and surgical variables were reviewed and their association with the stabilization time was determined through a multivariable analysis. RESULTS: A total of 144 renal units were analyzed. Mean age at surgery was 39.5 months (0 - 232 months). Pyeloplasty was open in 63% and robotic in 37% of the renal units. US variables are listed in Table 1. The median time to US stabilization was 10 months. Compared to the preoperative US grade of hydronephrosis, 85.5% of the patients improved, 14% remained equal and 0.5% worsened. Pyeloplasty failure was diagnosed with MAG 3 renal scan and US in 6% of the patients in a median of 7.5 months [IQR: 2-18.5]. After the median hydronephrosis stabilization, none of the patients required any additional intervention. From the analyzed variables only the preoperative grade of hydronephrosis did impact the SFU grade in which stabilization occurred (p<0.001), with greater preoperative grades stabilizing in a higher SFU grade. CONCLUSIONS: Median time to hydronephrosis stabilization in this large cohort was 10 months, suggesting that follow-up after a pyeloplasty should not be less than 1 year. Conversely, our findings suggest that clinicians can observe asymptomatic patients without immediate hydronephrosis improvement after a pyeloplasty, as there is often a lag time until stabilization. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e793-e794 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Maria C. Suarez More articles by this author Isabella Cabrera More articles by this author Daniel E. Nassau More articles by this author Ruben Blachman-Braun More articles by this author Justin Achua More articles by this author David Valancy More articles by this author Christopher Olson More articles by this author Christian Guevara More articles by this author Raquel Quintanilla More articles by this author Alireza Alam More articles by this author Andrew Labbie More articles by this author Rafael Gosalbez More articles by this author Miguel A. Castellan More articles by this author Expand All Advertisement Loading ...