Intermediate term outcomes associated with the surveillance of ureteropelvic junction obstruction in adults.

C. Gurbuz, S. L. Best, C. Donnally, S. Mir, Margaret S Pearle, Jeffrey A Cadeddu

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3 Citations (Scopus)

Abstract

We determined the outcome of minimally symptomatic adult ureteropelvic junction obstruction in a group of patients treated conservatively with an active surveillance regimen. A total of 27 patients with asymptomatic or minimally symptomatic ureteropelvic junction obstruction were treated conservatively. All patients were evaluated with diuretic renograms. Ureteropelvic junction obstruction was defined by an obstructive pattern of the clearance curve and/or T1/2 greater than 20 minutes. Followup consisted of an office visit and renogram every 6 to 12 months. Cases of greater than 10% loss of relative renal function of the affected kidney, development of pyelonephritis and/or more than 1 episode of acute pain were considered active surveillance failures, and treatment was recommended. Of the 27 patients 6 were lost to followup, leaving 21 (median age 47 years) with sufficient followup for analysis. In the 4 patients (19%) who initially presented with mild pain that led to the diagnosis of ureteropelvic junction obstruction, the pain completely resolved. Ipsilateral relative renal function decreased significantly in 2 patients (9.5%, mean reduction 14%). Pain worsened in 3 patients (14.3%) and de novo pain occurred in 1 (4.7%). Surgical intervention for ureteropelvic junction obstruction was required in 6 patients (29%) at an average of 34 months. In total 15 patients (71%) remained on surveillance with a mean followup of 48 months. Active surveillance seems to be a reasonable initial option for asymptomatic or mildly symptomatic adult patients with ureteropelvic junction obstruction because only approximately 30% have progression to surgical intervention within 4 years of diagnosis. This strategy offers the advantage of individualizing therapy according to symptoms and renographic findings.

Original languageEnglish (US)
Pages (from-to)926-929
Number of pages4
JournalThe Journal of urology
Volume185
Issue number3
StatePublished - Mar 2011

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Pain
Kidney
Office Visits
Pyelonephritis
Acute Pain
Treatment Failure
Diuretics
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

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Intermediate term outcomes associated with the surveillance of ureteropelvic junction obstruction in adults. / Gurbuz, C.; Best, S. L.; Donnally, C.; Mir, S.; Pearle, Margaret S; Cadeddu, Jeffrey A.

In: The Journal of urology, Vol. 185, No. 3, 03.2011, p. 926-929.

Research output: Contribution to journalArticle

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