Pyeloplasty in the young infant.

The urgency, safety and benefits of performing pyeloplasty during the first weeks of life currently are being questioned. We reviewed our experience with 114 pyeloplasties in 103 infants and young children performed between 1983 and 1987. The 34 patients who underwent an operation before they were 3 months old were compared to 69 operated upon after 3 months. The surgical results in the 2 groups were equally good, with 90 per cent of the cases having an improved or stable postoperative excretory urogram or renal scan. Complications were few and were more common in the older age group, in which 7 children required a secondary procedure, including 2 for recurrent obstruction at the ureteropelvic junction. No patient in the younger age group required a secondary procedure for treatment of a complication or recurrent obstruction. Our findings indicate that the success of pyeloplasty performed during the first weeks of life is equal to that performed at a later patient age and were not more likely to be followed by a complication.