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Evaluation of the Effect of Newborn Percutaneous Nephrostomy on Final Differential Renal Function in Severe UPJO, A Preliminary Study
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Seyed moohammadreza Rabani1   , Hamid Niknam2 |
1- , smrrabani@gmail.com
2- '' & '' |
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Abstract: (33 Views) |
Background and Aim
Uretero-pelvic junction obstruction (UPJO) is one of the most common congenital anomalies in Genito-urinary tract system. Although the effective and definite treatment for this congenital anomaly is surgical intervention, but due to possibility of gradual renal function improvement in some cases, usually the politic of post ponding the operation is suggested. On the other hand, it is mentioned that a significant part of the kidney growth is happen in the first two years of life. To use this golden time, it seems that it’s better to open the way as soon as possible and percutaneous nephrostomy (PCN) will be a simple and minimally invasive technique for this purpose. We have evaluated a group of newborns with severe UPJO who underwent PCN, when they were in the neonatal period, to estimate the effect of intervention time on the outcome of differential renal function of the affected kidney with severe UPJO.
Methods
This study was done on patients who underwent PCN in neonatal period from 2014 till 2024. The patients who were suspected for vesico-ureteral reflux, and cases with bilateral UPJO were excluded. Almost all of the patients were diagnosed in the intrauterine period by ultrasound protocol ordered by guidelines and re-evaluated by the first week ultrasound and confirmed by the first week DTPA renal scanning. The duration of nephrostomy was 4 to 8 weeks, and the final evaluation was based on the second DTPA scanning and its comparison with the baseline DTPA scanning. Severe UPJO was defined as differential renal function below 40% and A-P diameter of renal pelvis more than 20mm.
Results
Twelve infants including 8 boys were enrolled in this study. The results of the evaluation were summarized in the below table.
| ID |
Duration of PCN in weeks |
DRF IN BASELINE DTPA Scanning |
DRF IN FINAL DTPA Scanning |
RESULTS |
| 1 |
4 |
22 |
35 |
+13 |
| 2 |
6 |
20 |
32 |
+12 |
| 3 |
5 |
29 |
36 |
+7 |
| 4 |
6 |
30 |
38 |
+8 |
| 5 |
4 |
27 |
35 |
+8 |
| 6 |
4 |
21 |
33 |
+12 |
| 7 |
6 |
15 |
27 |
+12 |
| 8 |
4 |
38 |
44 |
+6 |
| 9 |
5 |
22 |
31 |
+9 |
| 10 |
7 |
10 |
20 |
+10 |
| 11 |
8 |
30 |
39 |
+9 |
| 12 |
4 |
32 |
42 |
+10 |
Conclusions
According to the results of this study, noting the effect of golden time for opening the way of an obstructed kidney, PCN in neonatal period may be a safe and effective way for improving differential renal function in newborns with severe UPJO, but more studies with greater samples are needed to confirm this idea. This simple procedure may provide a better occasion for reducing anaesthesia related complications of pyeloplasty.
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| Keywords: Key Words: Ureteropelvic Junction Obstruction(UPJO), Newborn, Percutaneous Nephrostomy(PCN) |
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Type of Study: Research |
Subject:
Urology
Received: 2024/12/13 | Accepted: 2026/09/5 | Published: 2026/10/5
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