Internal drainage (DJ stent) to predict recovery potential of poorly functioning kidney prior to pyeloplasty

We read with interest the article by Abbas et al. [ [1] Abbas T. Elifranji M. Al-Salihi M. Ahmad J. Vallasciani S. Elkadhi A. et al. Functional recoverability post-pyeloplasty in children with ureteropelvic junction obstruction and poorly functioning kidneys: systematic review. J Pediatr Urol. 2022; https://doi.org/10.1016/j.jpurol.2022.07.009 Abstract Full Text Full Text PDF Scopus (2) Google Scholar ] on functional recoverability in poorly functioning kidney (PFK) with uretero pelvic junction obstruction (UPJO) following pyeloplasty. The authors have included all units with less than 30% differential renal function (DRF), whereas the actual controversy lies in those with <10% DRF. Sarhan et al. [ [2] Sarhan O. Al Otay A. Al Faddagh A. El Helaly A. Al Hagbani M. Al Ghanbar M. et al. Pyeloplasty in children with low differential renal function: functional recoverability. J Pediatr Urol. 2021; 17: 658.e1-658.e9https://doi.org/10.1016/j.jpurol.2021.07.003 Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar ] have reported good recovery in units with <20% DRF, however the median age in their study was only 2 years. We have earlier shown that infants demonstrated better functional recovery following pyeloplasty [ [3] Chandrasekharam V.V.S. Babu R. Arlikar J. Satyanarayana R. Murali Krishna N. Functional outcomes of pediatric laparoscopic pyeloplasty: post-operative functional recovery is superior in infants compared to older children. Pediatr Surg Int. 2021; 37: 1135-1139https://doi.org/10.1007/s00383-021-04914-1 Crossref PubMed Scopus (0) Google Scholar , [4] Babu R. Rathish V.R. Sai V. Functional outcomes of early versus delayed pyeloplasty in prenatally diagnosed pelvi-ureteric junction obstruction. J Pediatr Urol. 2015; 11https://doi.org/10.1016/j.jpurol.2014.10.007 Abstract Full Text Full Text PDF PubMed Scopus (34) Google Scholar ]. The authors have not done sub group analysis of the age and many who recovered in <10% group might have been infants. Challenging the practice of straightforwardly removing “poorly functioning” kidney with ureteropelvic junction obstructionJournal of Pediatric UrologyPreviewWe value the chance to react to our colleagues' thoughtful comments of our article “Functional recoverability post-pyeloplasty in children with ureteropelvic junction obstruction and poorly functioning kidneys: Systematic review” [1] as well as their interesting remarks. Full-Text PDF