128 / 492
S8-10
(P)
URETEROPELVIC JUNCTION OBSTRUCTION: IS THERE ANY BENEFIT FROM
VOIDING CYSTOURETHROGRAPHY IN CHILDREN WITH NON-DILATED URETERS?
Mohammed Said ELSHEEMY, Ahmed SHOUMAN, Waseem ABOULELA, Kareem DAW, Ahmed I SHOUKRY, Hany MORSI
and Hesham BADAWY
Cairo University, Urology, Cairo, EGYPT
PURPOSE
To best of our knowledge, present study may be first one assessing value of voiding cystourethrography(VCUG) in
children with non-dilated ureters before doing pyeloplasty for correction of ureteropelvic junction obstruction(UPJ-O)
MATERIAL AND METHODS
Records of all cases of pyeloplasty in children4cm or split renal functions(SRF)<40% or deteriorating during follow-up.
Dismembered pyeloplasty was done through flank incision. Post-operative follow-up was done for at least 1year with
urine analysis, US and DTPA. Any abnormality in pre-operative VCUG was recorded to assess its effect on treatment
decision and any intra-operative findings
RESULTS
96children(68boys, 28girls) were included. Mean age was 6.39±3.57(1-12)months. At time of pyeloplasty, mean APPD
and SRF were 40.7±8.7(30-76)mm and 34.9±9.7%(5-50); respectively. According to SFU grading system for
hydronephrosis, 43children had grade3 while 53children had grade4. 5children only(4ipsilateral(4.16%), 1contralateral)
had vesicoureteric reflux during VCUG(all were grade1). Intra-operatively, crossing renal vessels and relatively long
atretic segments were detected in 3 and 4cases; respectively. The 4children with reflux had median SRF of 32%(26-40)
which improved 1year post-operatively to 34%(28-44). They had no fever or urinary tract infections during follow-up
CONCLUSIONS
When there are no voiding symptoms, ureteric dilatation or suspected bladder and ureteric abnormalities in pre-
operative ultrasound, VCUG can be omitted as it will not affect the treatment decision or operative outcome in children
with UPJ-O