OBJECTIVE: To compare treatment results in patients who underwent pyeloplasty with and without pelvic reduction for ureteropelvic junction obstruction (UPJO). METHODS: This randomized prospective study involved 40 patients, all diagnosed with unilateral UPJO; 20 each were randomly selected to undergoopen dismembered pyeloplasty with pelvic reduction (group A) or pelvis-sparing pyeloplasty (group B). Patients were evaluated with ultrasound and DPTA renography scans 6 months postoperatively. Mean follow-up was 9 months. RESULTS: The mean age in group B was 5.71 ± 6.36 years; in group A it was 4.81 ± 6.78 years. There was a decrease in mean anteroposterior renal pelvic diameter (from 49.9 to 26.35 ± 0.949 mm in A and 50.9 to 30.8 ± 1.556 mm in B) with improvement of split renal function (from 39 ± 22.47% to 42.4 ± 22.13% in A and 34.92 ± 16.79% to 38.8 ± 19.66% in B), glomerular filtration rate (from 37.25 ± 15.33 to 41.7 ± 19.34 ml/min in A and 31.3 ± 18.50 to 38.1 ± 23.23 ml/min in B) and draining curves on the 6-month scans, but without any significant difference between groups (p > 0.05). Two cases in group A and three in group B needed redo pyeloplasty, but without any significant difference in failure rate. CONCLUSION: Excision of the pelvis is not necessary in dismembered pyeloplasty procedures. We had similar surgical outcomes for patients with or without pelvis reduction.
RCT Entities:
OBJECTIVE: To compare treatment results in patients who underwent pyeloplasty with and without pelvic reduction for ureteropelvic junction obstruction (UPJO). METHODS: This randomized prospective study involved 40 patients, all diagnosed with unilateral UPJO; 20 each were randomly selected to undergo open dismembered pyeloplasty with pelvic reduction (group A) or pelvis-sparing pyeloplasty (group B). Patients were evaluated with ultrasound and DPTA renography scans 6 months postoperatively. Mean follow-up was 9 months. RESULTS: The mean age in group B was 5.71 ± 6.36 years; in group A it was 4.81 ± 6.78 years. There was a decrease in mean anteroposterior renal pelvic diameter (from 49.9 to 26.35 ± 0.949 mm in A and 50.9 to 30.8 ± 1.556 mm in B) with improvement of split renal function (from 39 ± 22.47% to 42.4 ± 22.13% in A and 34.92 ± 16.79% to 38.8 ± 19.66% in B), glomerular filtration rate (from 37.25 ± 15.33 to 41.7 ± 19.34 ml/min in A and 31.3 ± 18.50 to 38.1 ± 23.23 ml/min in B) and draining curves on the 6-month scans, but without any significant difference between groups (p > 0.05). Two cases in group A and three in group B needed redo pyeloplasty, but without any significant difference in failure rate. CONCLUSION: Excision of the pelvis is not necessary in dismembered pyeloplasty procedures. We had similar surgical outcomes for patients with or without pelvis reduction.