Moderate approach to the antenatally diagnosed unilateral ureteropelvic junction obstruction: experience with 93 patients

To evaluate the results of the treatment in patients with antenatally detected unilateral ureteropelvic junction obstruction. Ninety-three patients were analyzed according to the radiologic and scintigraphic findings and mode of the treatment. Fifty-eight patients were treated surgically while 29 patients were followed conservatively. All patients were reevaluated at the first year of the treatment with diuretic renogram (DR). Follow-up procedure was finished at first postoperative year in surgically treated patients, while mean follow-up duration was 14.9±6.9 months for the conservatively treated group. In the operated group, pelvic diameter was greater than 20 mm on ultrasound and overall rate of mean split renal function was 38.65±9.55% on DR and 39.65±12.55% at first postoperative year. In the conservatively treated group, mean split renal function was 46.17±3.42 at the beginning and 47.48±4.00 at first year of follow-up. Sixty-three percent of the patients underwent pyeloplasty while 83% of them were showing obstructive pattern on DR. We believed that surgery should be done in renal units which showed pelvic diameter greater than 20 mm and less than 40% of split renal function, while others might be followed conservatively, with or without an obstructive pattern on DR.