[Pyeloplasty follow-up. How and how long?].

INTRODUCTION: Some controversies still persist about the pueloplasty follow-up and this study aims to determine which test should be done in these patients during the follow-up and for how long these patients should be under control. PATIENTS AND METHODS: Forty six children who underwent to pueloplasty were retrospectively reviewed and those with contralateral renal abnormalities were excluded from study. Six children were lost to follow-up and were excluded. Of 40 p (25 M, 14 F) who fulfilled the requirements of this study, 28 were diagnosed prenatally and 28 had a left UPJ obstruction. All children were diagnosed by renal ultrasound, diuretic renography and excretory urogram (except 2). Mean age at Anderson Hynes pyeloplasty was 5.1 months and mean follow-up was 6.1 years. Renal ultrasound at 3 months and every year, and a diuretic renography at 1 year were performed in all children during follow-up. In some of them diuretic renography was repeated. RESULTS: At 3 months renal ultrasound demonstrated a significant hydronephrosis decrease in all children (p < 0.0001) but not in further controls. Differential renal function remained unchanged after pyeloplasty and during follow-up. However, there was a significant UPJ drainage improvement after pyeloplasty and during follow-up (p < 0.0001, p < 0.005). Any child needed a second pyeloplasty procedure and all of them showed a normal UPJ drainage in the antegrade ureterogram performed on the 5th postoperative day, except one. CONCLUSIONS: Differential renal function did not improve after pyeloplasty in our children. If renal ultrasound 3 months after pyeloplasty demonstrated a significant hydronephrosis decrease and at 1 year diuretic renography reveals a normal UPJ drainage any change should be expected in the long-term follow-up.