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Outcome study of upper pole heminephroureterectomy in children.
MedLine Citation:
PMID:  21069568     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: We assessed the role and long-term outcome of upper pole heminephroureterectomy in the treatments of non-functioning upper renal moieties in children with duplex kidneys.
METHODS: In a period of 10 years, forty-three patients (male: female ratio 6:37) underwent upper pole heminephroureterectomy; a total of 25 patients were diagnosed prenatally. Imaging modalities included renal and bladder ultrasound in all 43 patients, static 99 m technetium dimercaptosuccinic acid (DMSA) in 21 patients, micturating cystourethrogram in 28 patients, MAG-3 in 13, cystoscopy in 30, IVU in 31 and DTPA, retrograde pyelography, antegrade pyelography in 1 patient. The main presentation was with urinary tract infections. Operation was performed through a combination of anterolateral loin incision plus right or left inguinal incision in 34 patients and high flank incision in 9 patients, for various abnormalities. One patient underwent also initial puncture of a ureterocele.
RESULTS: Five patients (12%) had immediate post-operative complications. Thirteen patients (30%) had late post-operative complications. Long-term follow-up revealed no complication in 35 (81%) patients and one (2%) patient had one episode of UTI and intermittent abdominal pain. Three patients (7%) had long-term incontinence. Four patients (9%) had a second procedure performed.
CONCLUSION: Based on our experience, it seems that upper pole heminephroureterectomy is the treatment of choice in cases of obstructed upper segments of duplicated kidneys, when the affected segment contributes to less than 10% of the overall renal function.
Authors:
George Sakellaris; Sisil Kumara; Raimondo M Cervellione; Alan P Dickson; David Gough; Supul Hennayake
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Publication Detail:
Type:  Journal Article     Date:  2010-11-12
Journal Detail:
Title:  International urology and nephrology     Volume:  43     ISSN:  1573-2584     ISO Abbreviation:  Int Urol Nephrol     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0262521     Medline TA:  Int Urol Nephrol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  279-82     Citation Subset:  IM    
Affiliation:
Department of Paediatric Urology, Central Manchester and Manchester Children's University Hospital NHS Trust, Manchester, M27 4HA, UK, gsakell@mycosmos.gr.
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