Skip to main content

Advertisement

SpringerLink
Log in

Ureteropelvic junction obstruction with polyps in children: clinical manifestations and supranormal preoperative differential renal function

  • Urology - Original Paper
  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

Objective

To describe and analyze the clinical manifestation and pre-DRF of UPJO children with polyps and explore the possible influencing factors of supranormal pre-DRF.

Patients and methods

All patients undergoing primary Anderson-Hynes pyeloplasty for UPJO due to polyp were retrospectively reviewed. Patients’ characteristics, parameters of ultrasound and dynamic renograms (DR) were recorded in elaborate. Pre-DRF in groups of different age, weight, gender, pain, grade of hydronephrosis, anterio-posterior pelvic diameter (APD), length of kidney and postoperative ultrasonic parameters were compared.

Results

A total of 18 UPJO children with polyps were included. Five (27.78%) patients had SFU III grade of hydronephrosis. Seven (38.89%) patients were supranormal pre-DRF. All patients had pre-DRF > 40%. Drainage curve was delayed excretion in 12 (66.67%) patients and T1/2 < 20 min was in 4 (22.22%) patients. Among the 16 patients who underwent preoperative IVP examination, 15 (93.75%) patients had concentration of intrarenal pelvis contrast agent within 10 min. No significant difference in post-APD reduction rate and post-minPT increased was found between supranormal pre-DRF and non-supranormal pre-DRF groups. The supranormal pre-DRF was more likely to occur in young and low-weight children.

Conclusion

The preoperative renal function of UPJO patients with polyps was well preserved, and 38.89% of them had supranormal pre-DRF. Patients with supranormal pre-DRF can be managed with the same strategies as those with normal renal function.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

Data for this study will be provided by the corresponding author for reasonable reasons.

References

  1. McGrath M, Jegatheeswaran K, Braga LH (2019) Medusa’s curls: Ureteropelvic junction obstruction secondary to multiple long intraluminal polyps. Urology 130:138–141

    Article  PubMed  Google Scholar 

  2. Rickard M, Braga LH, Gandhi S, Oliveria JP, Demaria J, Lorenzo AJ (2017) Comparative outcome analysis of children who underwent pyeloplasty for ureteropelvic junction obstruction associated with or without supranormal differential renal function. Urology 99:210–214

    Article  PubMed  Google Scholar 

  3. Maenhout A, Ham H, Ismaili K, Hall M, Dierckx RA, Piepsz A (2005) Supranormal renal function in unilateral hydronephrosis: does it represent true hyperfunction? Pediatr Nephrol 20:1762–1765

    Article  PubMed  Google Scholar 

  4. Martin-Sole O, Soria-Gondek A, Perez-Bertolez S, Paredes P, Tarrado X, Garcia-Aparicio L (2019) Value of supranormal function on (99m) Tc-mercaptoacetyltriglycine renal scan in paediatric patients with obstructive hydronephrosis. BJU Int 124:842–848

    Article  CAS  PubMed  Google Scholar 

  5. Ozcan Z, Anderson PJ, Gordon I (2006) Robustness of estimation of differential renal function in infants and children with unilateral prenatal diagnosis of a hydronephrotic kidney on dynamic renography: how real is the supranormal kidney? Eur J Nucl Med Mol Imaging 33:738–744

    Article  PubMed  Google Scholar 

  6. Osbun N, Ellison JS, Lendvay TS (2016) Robot-assisted laparoscopic excision of ureteral and ureteropelvic junction fibroepithelial polyps in children. J Endourol 30:896–900

    Article  PubMed  Google Scholar 

  7. Pippi Salle JL, Cook A, Papanikolaou F, Bagli D, Breen SL, Charron M et al (2008) The importance of obtaining conjugate views on renographic evaluation of large hydronephrotic kidneys: an in vitro and ex vivo analysis. J Urol 180:1559–1565

    Article  PubMed  Google Scholar 

  8. Bian Z, Liu X, Hua Y, Liu F, Lin T, He D (2011) Laparoscopic management of multiple ureteral polyps in children. J Urol 186:1444–1449

    Article  PubMed  Google Scholar 

  9. Patel RV, Johal N, Evans K, Mushtaq I (2014) Antenatal mild hydronephrosis with subsequent polyp of the upper ureter in a child presenting with recurrent Dietl’s crisis. BMJ Case Rep. https://doi.org/10.1136/bcr-2013-202967

    Article  PubMed  PubMed Central  Google Scholar 

  10. Gu J, Li D, Shang L, Chen X, Dai Y, Deng X et al (2021) Thulium laser in the management of ureteral fibroepithelial polyps: a multicenter retrospective study. J Laparoendosc Adv Surg Tech A 31:1241–1246

    Article  PubMed  Google Scholar 

  11. Chen Z, Lin H, Xu M, Xu G, Fang X, He L et al (2020) The clinical manifestations of intermittent hydronephrosis and their relationship with renal function in pediatric patients. J Pediatr Urol 16(458):e1–e6

    Google Scholar 

  12. He Y, Song H, Liu P, Sun N, Tian J, Li M et al (2020) Primary laparoscopic pyeloplasty in children: a single-center experience of 279 patients and analysis of possible factors affecting complications. J Pediatr Urol 16(331):e1–e11

    Google Scholar 

  13. Yucel OB, Donmez MI, Kucukgergin C, Ziylan O, Seckin S, Oktar T (2022) Urinary biomarkers can identify the need for pyeloplasty in presence of supranormal differential renal function in antenatally diagnosed unilateral hydronephrosis. J Pediatr Urol 18:6–12

    Article  PubMed  Google Scholar 

  14. Hung ND, Ngan VK, Hieu ND, Duc NM (2021) Benign ureteral polyps causing upper urinary tract obstruction. Urol Case Rep 37:101619

    Article  PubMed  PubMed Central  Google Scholar 

  15. Oh SJ, Moon DH, Kang W, Park YS, Park T, Kim KS (2001) Supranormal differential renal function is real but may be pathological: assessment by 99m technetium mercaptoacetyltriglycine renal scan of congenital unilateral hydronephrosis. J Urol 165:2300–2304

    Article  CAS  PubMed  Google Scholar 

  16. Ham WS, Jeong HJ, Han SW, Kim JH, Kim DK (2004) Increased nephron volume is not a cause of supranormal renographic differential renal function in patients with ureteropelvic junction obstruction. J Urol 172:1108–1110

    Article  PubMed  Google Scholar 

  17. Tsai JD, Huang FY, Lin CC, Tsai TC, Lee HC, Sheu JC et al (2006) Intermittent hydronephrosis secondary to ureteropelvic junction obstruction: clinical and imaging features. Pediatrics 117:139–146

    Article  PubMed  Google Scholar 

  18. Aktas GE, Sarikaya A (2015) Correction of differential renal function for asymmetric renal area ratio in unilateral hydronephrosis. Ann Nucl Med 29:816–824

    Article  PubMed  Google Scholar 

  19. Gungor F, Anderson P, Gordon I (2002) Effect of the size of regions of interest on the estimation of differential renal function in children with congenital hydronephrosis. Nucl Med Commun 23:147–151

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

None.

Funding

None.

Author information

Author notes

  1. Yuzhu He and Yi Li have contributed equally and should be considered co-first authors.

Authors and Affiliations

  1. Department of Urology, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, No. 56 Nanlishi St, Xicheng District, Beijing, 100045, China

    Yuzhu He, Yi Li, Hongcheng Song & Weiping Zhang

  2. Department of Imaging, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, 100045, China

    Jihang Sun

  3. Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China

    Jigang Yang

Authors
  1. Yuzhu He
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yi Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jihang Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jigang Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hongcheng Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Weiping Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Weiping Zhang.

Ethics declarations

Ethical approval

This work was approved by the local ethics board of Beijing Children’s Hospital, Beijing, China (No.: [2023]-E-038-R).

Conflict of interest

We declare that none of the authors have any potential financial conflict of interest related to this manuscript. This work has not been published elsewhere, and the manuscript is not currently under consideration by any other journal.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

He, Y., Li, Y., Sun, J. et al. Ureteropelvic junction obstruction with polyps in children: clinical manifestations and supranormal preoperative differential renal function. Int Urol Nephrol 56, 373–380 (2024). https://doi.org/10.1007/s11255-023-03827-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-023-03827-3

Keywords

Search

Navigation