Efficacy evaluation of Anderson-Hynes pyeloplasty in unilateral ureteropelvic junction obstruction patients by diuretic renography

Objectives To evaluate the efficacy of Anderson-Hynes pyeloplasty in unilateral ureteropelvic junction obstruction (UPJO) patients using diuretic renography, and analyze the possible factors related to postoperative renal function improvement.

Methods Forty-two patients who underwent Anderson-Hynes pyeloplasty for diagnosed unilateral UPJO, were retrospectively collected. All patients underwent diuretic renography before and after surgery. The relative renal function (RRF) of affected kidney was expressed as its uptake rate in second to third minute post injection of the imaging agent. Obstructive and non-obstructive hydronephrosis was classified according to the response to furosemide stimulation (RFS). P<0.05 was considered statistically significant.

Results The RRF of affected kidney before operation was (40.40±13.45)%, and that of post operation was (44.26±13.35)%, indicating a statistically significant renal function improvement after surgery (P=0.01).Postoperative drainage improvement was found in 51.5%(17/33) patients, with unchanged in 48.5%(16/33). Patients with postoperative drainage improvement were 53.33% (8/15), 56.00% (14/25) and 50.00% (1/2) in the group of renal function improved, unchanged and deteriorated respectively, which were no of significant difference (P=0.21). There was not significant correlation between postoperative renal function improvements with preoperative renal function (P=0.40), and neither with preoperative obstruction or non-obstruction (P=0.60).

Conclusions Anderson-Hynes pyeloplasty could improve UPJO patients’ involved renal function, and better some patients’ drainage conditions. However, there is not any significant correlation between the postoperative renal function improvements with drainage improvement. Preoperative renal function and obstructive types could not be used to predict the improvement of renal function post operation.