Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

11:37 - 11:40

S8-2

(PP)

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ISOLATED LOW INITIAL RENAL FUNCTION IN PATIENTS WITH PRIMARY NON-

REFLUXING MEGAURETER SHOULD NOT BE CONSIDERED AN INDICATION FOR

EARLY SURGERY: A MULTICENTRIC STUDY

Marcel DRLÍK

, Hana FLOGELOVÁ

, Martin KUBÁT

, Jan TOMÁŠEK

, Pavel ZERHAU

, Oldrich ŠMAKAL

, Ivo NOVÁK

Martin KOMARC

and Radim KOCVARA

1) General Teaching Hospital and Charles University 1-st Faculty of Medicine, Urology, Prague, CZECH REPUBLIC - 2)

Olomouc University Hospital, Pediatrics, Olomouc, CZECH REPUBLIC - 3) Brno University Hospital, Paediatric Surgery,

Brno, CZECH REPUBLIC - 4) Hradec Králové University Hospital, Urology, Hradec Králové, CZECH REPUBLIC - 5)

Olomouc University Hospital, Department of Urology, Olomouc, CZECH REPUBLIC - 6) General Teaching Hospital and

Charles University 1-st Faculty of Medicine, Biomedicine, Prague, CZECH REPUBLIC

PURPOSE

Low initial differential renal function (DRF) in patients with primary non-refluxing megaureter (PNRM) is considered a

current indication for surgery besides an increase of dilatation and symptoms. We conducted a multicentric study

focusing on significance of low initial DRF, because relevant data are lacking.

MATERIAL AND METHODS

We reviewed data from four university centres between 1995 and 2010. Patients under 12 months of age with

unilateral PNMR and a DRF between 10 and 40%, and followed minimally 24 months, were included. Patients were

placed in two groups based on management: group A- surgical (16 pts), group B - conservative (9 pts). Dynamics of

DRF in relation to age and type of treatment was studied.

RESULTS

Initial mean DRF in group A was 32.6 % (+/-1.4), in group B 34.5 % (+/-1.5) at a mean age 3.2 (+/-0.6) and 3.6

(+/-1.1) months respectively. The final mean DRF in group A was 40.1% (+/-2.6), in group B 43.3% (+/-2.2) at a

mean age 59.9 (+/-9.1) and 46.3 (+/-8.3) months respectively (p = 0.338). A statistically significant increase of DRF

was similar in both groups (p = 0.001) at comparable age.

CONCLUSIONS

Low DRF in asymptomatic and anatomically stable patients with PNMR should not be considered an indication for early

surgery. These findings challenge current practice and should be confirmed by prospective study.