Managing Ureteropelvic Junction Obstruction in the Young Infant

Frontiers in Pediatrics
Niccolo Maria Passoni, Craig A Peters

Abstract

In the last decade, management of congenital UPJ obstruction has become progressively observational despite the lack of precise predictors of outcome. While it is clear that many children will have resolution of their hydronephrosis and healthy kidneys, it is equally clear that there are those in whom renal functional development is at risk. Surgical intervention for the young infant, under 6 months, has become relatively infrequent, yet can be necessary and poses unique challenges. This review will address the clinical evaluation of UPJO in the very young infant and approaches to determining in whom surgical intervention may be preferable, as well as surgical considerations for the small infant. There are some clinical scenarios where the need for intervention is readily apparent, such as the solitary kidney or in child with infection. In others, a careful evaluation and discussion with the family must be undertaken to identify the most appropriate course of care. Further, while minimally invasive pyeloplasty has become commonly performed, it is often withheld from those under 6 months. This review will discuss the key elements of that practice and offer a perspective of where minimally invasive pyeloplasty is of value in the ...Continue Reading

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Citations

Aug 20, 2021·Research and Reports in Urology·Irfan WahyudiArry Rodjani
Jan 14, 2022·Pediatric Radiology·J Damien Grattan-SmithRichard Alan Jones

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