LAD pyeloplasty versus open in UPJO with poorly functioning kidney in pediatrics: response to editors

Comments to editors and reader

Thanks Sir for your opinion and comments, but I have few points to discuss:

• 1. We follow STROBE guidelines.

• 2. The renal function loss was in the cases of severely poor and markedly renal parenchymal loss after pyeloplasty, so that, required nephrectomy for fear of complications.

• 3. I appreciate your believes for necessary placing of PCN before pyeloplasty, but this method didn’t have consensus by many surgeons,  and carries a lot of hazards, as damage of renal parenchyma, infection and abscess formation,  in addition to exposure to anesthesia and repeated hospital admission with repeated exposure to Isotope scan after PCN. So I believe that pyeloplasty is the best procedure for renal salvage.