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Long-term outcomes after pyeloplasty for pelvi-ureteric junction obstruction in adults associated with renal congenital anomalies: Age, sex and renal function matched analysis

Objective: To assess the long-term outcomes after pyeloplasty for pelvi-ureteric junction obstruction (PUJO) associated with renal anomalies. Patients and methods: Data were collected for patients after pyeloplasty for PUJO associated with renal anomalies and analysed retrospectively. Long-term func...

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Autores principales: Elbaset, Mohamed A., Osman, Yasser, Elgamal, Mostafa, Sharaf, Mohamed A., Ezzat, Osama, Elmeniar, Ali M., Abdelhamid, Abdalla, Zahran, Mohamad H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8158229/
https://www.ncbi.nlm.nih.gov/pubmed/34104493
http://dx.doi.org/10.1080/2090598X.2020.1816600
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author Elbaset, Mohamed A.
Osman, Yasser
Elgamal, Mostafa
Sharaf, Mohamed A.
Ezzat, Osama
Elmeniar, Ali M.
Abdelhamid, Abdalla
Zahran, Mohamad H.
author_facet Elbaset, Mohamed A.
Osman, Yasser
Elgamal, Mostafa
Sharaf, Mohamed A.
Ezzat, Osama
Elmeniar, Ali M.
Abdelhamid, Abdalla
Zahran, Mohamad H.
author_sort Elbaset, Mohamed A.
collection PubMed
description Objective: To assess the long-term outcomes after pyeloplasty for pelvi-ureteric junction obstruction (PUJO) associated with renal anomalies. Patients and methods: Data were collected for patients after pyeloplasty for PUJO associated with renal anomalies and analysed retrospectively. Long-term functional success was evaluated by comparing the renographic split renal function (SRF) and glomerular filtration rate (GFR) at last follow-up with baseline values. A change of 5% in SRF was considered significant. Factors affecting functional outcome were assessed. The outcomes were compared to an age, sex and renal function matched group with PUJO in otherwise normal kidneys (Group 2) to evaluate the pattern of difference in functional recoverability in both groups. This was assessed using repeated-measures analysis of variance. Results: The study initially included 70 adult patients, with a mean age of 31.8 years. At a median of 44 months, 55 patients completed follow-up (Group 1) and no statistically significant changes in GFR (P = 0.7) and SRF (P = 0.06) were found. In all, 17, four and 34 patients showed a decrease, increase and static SRF (functional success rate was 69%). Higher preoperative SRF (P = 0.02) and Anderson–Hynes (A–H) pyeloplasty (P = 0.003) were associated with functional preservation. In the comparison with the other matched group (Group 2), the patients in Group 2 had better functional recoverability after pyeloplasty than patients with associated anomalies [GFR (P = 0.001), SRF (P = 0.002) and functional success (P = 0.001)]. Conclusion: Functional preservation after pyeloplasty in associated renal anomalies could be achieved in 69% of patients, which was significantly lower than those with otherwise normal kidneys. A–H pyeloplasty and higher preoperative SRF were associated with better functional outcomes. Abbreviations: A–H: Anderson–Hynes; HSK: horseshoe kidneys; OR: odds ratio; PUJO: PUJ obstruction; SRF: split renal function; T(1/2), half-time
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spelling pubmed-81582292021-06-07 Long-term outcomes after pyeloplasty for pelvi-ureteric junction obstruction in adults associated with renal congenital anomalies: Age, sex and renal function matched analysis Elbaset, Mohamed A. Osman, Yasser Elgamal, Mostafa Sharaf, Mohamed A. Ezzat, Osama Elmeniar, Ali M. Abdelhamid, Abdalla Zahran, Mohamad H. Arab J Urol Reconstruction Objective: To assess the long-term outcomes after pyeloplasty for pelvi-ureteric junction obstruction (PUJO) associated with renal anomalies. Patients and methods: Data were collected for patients after pyeloplasty for PUJO associated with renal anomalies and analysed retrospectively. Long-term functional success was evaluated by comparing the renographic split renal function (SRF) and glomerular filtration rate (GFR) at last follow-up with baseline values. A change of 5% in SRF was considered significant. Factors affecting functional outcome were assessed. The outcomes were compared to an age, sex and renal function matched group with PUJO in otherwise normal kidneys (Group 2) to evaluate the pattern of difference in functional recoverability in both groups. This was assessed using repeated-measures analysis of variance. Results: The study initially included 70 adult patients, with a mean age of 31.8 years. At a median of 44 months, 55 patients completed follow-up (Group 1) and no statistically significant changes in GFR (P = 0.7) and SRF (P = 0.06) were found. In all, 17, four and 34 patients showed a decrease, increase and static SRF (functional success rate was 69%). Higher preoperative SRF (P = 0.02) and Anderson–Hynes (A–H) pyeloplasty (P = 0.003) were associated with functional preservation. In the comparison with the other matched group (Group 2), the patients in Group 2 had better functional recoverability after pyeloplasty than patients with associated anomalies [GFR (P = 0.001), SRF (P = 0.002) and functional success (P = 0.001)]. Conclusion: Functional preservation after pyeloplasty in associated renal anomalies could be achieved in 69% of patients, which was significantly lower than those with otherwise normal kidneys. A–H pyeloplasty and higher preoperative SRF were associated with better functional outcomes. Abbreviations: A–H: Anderson–Hynes; HSK: horseshoe kidneys; OR: odds ratio; PUJO: PUJ obstruction; SRF: split renal function; T(1/2), half-time Taylor & Francis 2020-09-02 /pmc/articles/PMC8158229/ /pubmed/34104493 http://dx.doi.org/10.1080/2090598X.2020.1816600 Text en © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Reconstruction
Elbaset, Mohamed A.
Osman, Yasser
Elgamal, Mostafa
Sharaf, Mohamed A.
Ezzat, Osama
Elmeniar, Ali M.
Abdelhamid, Abdalla
Zahran, Mohamad H.
Long-term outcomes after pyeloplasty for pelvi-ureteric junction obstruction in adults associated with renal congenital anomalies: Age, sex and renal function matched analysis
title Long-term outcomes after pyeloplasty for pelvi-ureteric junction obstruction in adults associated with renal congenital anomalies: Age, sex and renal function matched analysis
title_full Long-term outcomes after pyeloplasty for pelvi-ureteric junction obstruction in adults associated with renal congenital anomalies: Age, sex and renal function matched analysis
title_fullStr Long-term outcomes after pyeloplasty for pelvi-ureteric junction obstruction in adults associated with renal congenital anomalies: Age, sex and renal function matched analysis
title_full_unstemmed Long-term outcomes after pyeloplasty for pelvi-ureteric junction obstruction in adults associated with renal congenital anomalies: Age, sex and renal function matched analysis
title_short Long-term outcomes after pyeloplasty for pelvi-ureteric junction obstruction in adults associated with renal congenital anomalies: Age, sex and renal function matched analysis
title_sort long-term outcomes after pyeloplasty for pelvi-ureteric junction obstruction in adults associated with renal congenital anomalies: age, sex and renal function matched analysis
topic Reconstruction
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8158229/
https://www.ncbi.nlm.nih.gov/pubmed/34104493
http://dx.doi.org/10.1080/2090598X.2020.1816600
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