Primary non-surgical management of unilateral ureteropelvic junction obstruction in XXXX : a systematic review.

@entity1 @entity3551 @entity3041 @entity177 @entity4145
UNASSIGNED: @entity4145 ( @entity4145 ) is the most @entity3551 and its optimal management remains controversial. However, there is a current trend towards non-surgical management. We aimed to determine the effects of the non-surgical management in @entity1 with unilateral @entity4145 . For a systematic review, we searched MEDLINE, EMBASE, CENTRAL, clinical trials registries, and selected conference proceedings for eligible studies. Any type of study reporting the outcomes renal function, secondary surgical intervention, drainage pattern or @entity3041 of non-surgical management in @entity1 with unilateral @entity4145 was included. Data from 20 studies were extracted and evaluated by two independent authors. The pooled prevalence was 21% for @entity177 , 27.9% for secondary surgical intervention, 3.2% for progressive @entity3041 , and 82.2% for improved drainage pattern. Not all @entity1 with surgical intervention regained split renal function from enrolment. Renal imaging methods did not strongly correlate with each other. Many studies had to be excluded because of a lack of detection of an obstruction or mixed populations with bilateral @entity4145 or other uropathies. The variable definitions of @entity4145 , different criteria for surgical intervention, incongruity of management protocols, and the imprecise reporting of outcomes were limiting factors in the comparability of the results, leading to heterogeneity in meta-analyses. Although the available evidence cannot recommend or refute the current non-surgical management, the systematic review clarifies aspects of the ongoing controversy by providing realistic estimates for non-surgical management in @entity1 with unilateral @entity4145 . Additionally, it reveals unclear potential risks, particularly for long-term outcomes, which were rarely reported.
