ESPU Congress 2018 - Abstract Book

11–14 APRIL, 2018, HELSINKI, FINLAND

MATERIAL AND METHODS

We retrospectively reviewed pediatric UPJO treated with pyeloplasty or PCN at our institution from

7/1/2010 to 9/30/2017 to determine the rate of POD (urine output >300 % of calculated mainte-

nance fluid) in patients with a normal contralateral kidney. Patients with a solitary kidney or bilateral

procedures were excluded.

RESULTS

397/429 (92.5 %) patients with a normal contralateral kidney had treated UPJO. POD occurred

7 times (1.8 %): PCN (n=3), pyeloplasty (n=4). Median intervention age was 1.7 years (range

11 days – 18 years); median weight was 11.4 kg (range 3.7–54.2 kg). There was no significant

difference in age, gender, affected kidney laterality, differential kidney size or function between

those who developed POD and those who did not. Affected patients were managed with additional

intravenous fluids and frequent electrolyte monitoring. Median initial post-procedure urine output

was 5.9 mg/kg/hr (range 3.2 - 10.0 mg/kg/hr). Five had nephrostomy tubes following their proce-

dure; two had indwelling stents. In those with nephrostomy tubes, median initial post-procedure

urine output from the affected side was 6.1 mg/kg/hr (range 2.5–9.1 mg/kg/hr) and 0.8 mg/kg/

hr (range 0.4–0.9 mg/kg/hr) from the non-affected side. Median POD resolution was 3 days

(range 2–4 days). One patient developed acidosis, acute renal insufficiency and lethargy. Mild

hyponatremia developed in 2, hypokalemia in 1, hypomagnesemia in 0, hypophosphatemia in 1,

and hypoglycemia in 1.

CONCLUSIONS

POD after resolution of UPJO with pyeloplasty or PCN with a normal contralateral kidney is a rare

event (1.8 %) that requires careful monitoring given the potential for significant dehydration and

electrolyte disturbances.

09:57–10:00

S6-5 (PP)

PREDICTORS OF RECURRENCE AND COMPLICATIONS

IN PEDIATRIC PYELOPLASTY

Erman CEYHAN

, Fatih ILERI

, Taner CEYLAN

, Ahmet Murat AYDIN

Hasan Serkan DOGAN

and Serdar TEKGUL

1) Hacettepe University School of Medicine, Urology, Ankara, TURKEY - 2) Hacettepe University School of Medicine,

Pediatric Urology, Ankara, TURKEY - 3) Hacettepe University School of Medicine, Urology, Ankara, TURKEY

PURPOSE

Failed pyeloplasties are challenging cases. To point out ways of better manipulation we assessed

the predictors of recurrence and complications in pediatric pyeloplasty.

MATERIAL AND METHODS

We analyzed 490 renal units whom underwent primary dismembered pyeloplasty with eligible data

between June 2001 and October 2016 retrospectively. Patient’s demographic features, operative

data, clinical findings, complications and recurrence rates were evaluated.

RESULTS

The mean follow-up time after pyeloplasty was 47.6 (±37.7) months. Our recurrence and complica-

tion rates were 6.7 % and 11.4 %, respectively. Urinary tract infection (7.8 %), diversion related

complications (1.8 %) and urinoma (1.4 %) were the most common complications. Presence of

preoperative diversion (p=0.020) and experiencing early complications (p<0.001) after pyelo-

plasty were significantly related to recurrence. Complication rates were founded less in children with