Long-term results of pyeloplasty in poorly functioning kidneys in the pediatric age group

ObjectiveTo determine the efficacy and long-term outcome of pyeloplasty in poorly functioning kidneys in the pediatric age group.MethodRetrospective data analysis was performed on patients who underwent pyeloplasty in 2000–2008. The parameter analyzed was postoperative outcome. Success was defined on the basis of either improvement in symptoms or better drainage on postoperative Tc-99m DTPA renography done after 3 months and yearly thereafter.ResultsA total of 39 patients with a mean age of 8.6 years (4 months to 13 years), and male to female ratio of 3:1, with poor function on isotope renogram (<30%) were included in the study. Left to right side ratio was 1.3:1. Dismembered pyeloplasty was done in all patients. Laparoscopic pyeloplasty was done in 27 (66.7%) and open in 12 (33.3%) patients. Follow-up renograms were available for 35 patients: 31 showed improvement in drainage and no further deterioration in renal function and 4 showed an obstructed pattern; of these, two patients had significant deterioration in split function and the other two underwent redo pyeloplasty by open technique. At a mean follow up of 41.6 months (8–75), overall success rate was 90%.ConclusionPyeloplasty gives good intermediate-term results in poorly functioning kidneys in the pediatric age group.