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Pyeloplasty may reverse the effect of growth delay from ureteropelvic junction obstruction in infants

  • Urology - Original Paper
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Abstract

Purpose

To determine if children with UPJO demonstrate a clinically significant change in somatic growth following pyeloplasty.

Methods

We retrospectively evaluated the growth chart data of infants with SFU grade 3 or 4 congenital hydronephrosis at our institution from 2015 to 2022. Of those, 35 patients underwent pyeloplasty and 66 had no surgical intervention. Patients met criteria if they had SFU 3 or 4 hydronephrosis and MAG3 renal scan. If patients underwent surgery, height and weight percentiles were recorded from the pre-op and 6–16-month follow-up visits. In non-surgery patients, measurements were taken near the median age of surgery in the intervention group and 6–16 months later. Interval changes in group height and weight percentiles are compared for significant changes.

Results

The surgery and non-surgery groups did not differ in terms of gender (71% vs 74% Male), starting age (296 vs 244 days), starting weight (58th vs 52nd percentile), or time between measurements (255 vs 260 days), though the surgery group had significantly less height in the pre-operative period (43rd vs 55th percentile, p = 0.050) and were more likely to have delayed drainage on renal scan (83% w/delay vs 35%). The surgery group showed a significant increase in height (18.9 percentiles; 95% CI 11–27) and weight (6.0 percentiles; 95% CI 0.50–12) after intervention.

Conclusions

Patients with congenital hydronephrosis due to UPJO that underwent pyeloplasty showed a significant increase in weight and height at 6–16 months postoperatively compared to those that were managed with close observation. This suggests UPJO might lead to growth delay in infants.

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Data availability

The data that support the findings of this study are available from the corresponding author, ER, upon reasonable request.

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Authors and Affiliations

  1. Department of Urology, Kaiser Permanente, Los Angeles, CA, USA

    Eric J. Robinson

  2. Department of Urology, Oregon Health and Science University, Portland, OR, USA

    Aaron Bayne

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  1. Eric J. Robinson
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  2. Aaron Bayne
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Contributions

Conception and design: ER, AB; critical revision of the manuscript for scientific and factual content: ER, AB; data acquisition: ER; data analysis and interpretation: ER, AB; drafting the manuscript: ER, AB; statistical analysis: ER, AB, RA; supervision: AB.

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Correspondence to Eric J. Robinson.

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The authors have no financial or non-financial conflicts of interest to disclose.

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Supplementary Information

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Supplementary file1 (XLSX 28 KB)

11255_2023_3870_MOESM2_ESM.png

SUPPLEMENTARY FIGURE 1 Comparison of surgery and non-surgery height percentile distributions at initial and follow-up timepoints for patients with T1/2 greater than 20m on MAG3 renal scan (PNG 523 KB)

11255_2023_3870_MOESM3_ESM.png

SUPPLEMENTARY FIGURE 2 Comparison of surgery and non-surgery weight percentile distributions at initial and follow-up timepoints for patients with T1/2 greater than 20m on MAG3 renal scan (PNG 28 KB)

Supplementary file4 (PNG 29 KB)

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Robinson, E.J., Bayne, A. Pyeloplasty may reverse the effect of growth delay from ureteropelvic junction obstruction in infants. Int Urol Nephrol 56, 1227–1233 (2024). https://doi.org/10.1007/s11255-023-03870-0

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  • DOI: https://doi.org/10.1007/s11255-023-03870-0

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