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

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16:25 - 16:28
S19-4 (PP)
★ SFU VERSUS UTD GRADING SYSTEMS FOR PRENATAL HYDRONEPHROSIS: A
TIME TO RESOLUTION ANALYSIS
Luis BRAGA1, Melissa MCGRATH2, Mandy RICKARD1, Kizanee JEGATHEESWARAN2, Bethany EASTERBROOK2, Jorge
DEMARIA1 and Armando LORENZO3
1) McMaster University - McMaster Children's Hospital, Department of Surgery / Urology, Hamilton, CANADA - 2)
McMaster University, Department of Surgery-McMaster Pediatric Surgery Research Collaborative, Hamilton, CANADA - 3)
The Hospital for Sick Children, Department of Surgery / Urology, Toronto, CANADA
PURPOSE
The Urinary Tract Dilation (UTD) grading system for hydronephrosis (HN) was recently released to address potential
shortcomings of the current SFU classification. HN resolution is an important patient outcome and frequently discussed
with families during counselling. We sought to compare these 2 grading systems and their capability to predict the
natural progression of prenatal HN.
MATERIAL AND METHODS
565 patients with prenatal HN (UPJO, megaureter, VUR) have been prospectively screened between 2009-15; with 254
being excluded due to surgical procedures (n=75) and other anomalies (n=179). SFU and UTD HN grades collected at
baseline and last follow-up were compared to identify resolution trends in 311 eligible patients. HN resolution was
defined as APD≤10mm at last follow-up. Time to resolution was analyzed using Kaplan-Meier curves and log-rank tests.
RESULTS
Of 311 (80% male) patients, 226 (73%) resolved over a mean follow-up of 25.7±1.05 months. Average HN resolution
rate for SFU I and II was equivalent to that for UTD I (87%). Resolution rate for SFU III was similar to that of UTD II
(62% vs. 65%, p=0.9). HN resolution rate for SFU IV was not significantly different from that of UTD III (38% vs. 45%,
p=0.6) (Table). Kaplan-Meier curves showed that patients with distinctive baseline SFU and UTD grades had significantly
different resolution times for HN (p<0.001).
CONCLUSIONS
Resolution rates based on UTD grading system were not significantly different from those according to SFU classification.
This new grading system should not impact how families are counselled regarding the natural progression of prenatal
HN.
Grading System
# of patients with
resolved HN (%)
Total
Time to Resolution
(Months)
SFU I 44(92) 48 17.3±1.5
SFU II 97(82) 119 23.1±1.5
SFU III 78(62) 126 30.8±1.8
SFU IV 7(38) 18 35.7±4.3
UTD I 115(87) 133 19.8±1.1
UTD II 102(65) 158 27.9±1.8
UTD III 9(45) 20 34.2±3.9