Can severely impaired cortical transit predict which XXXX with pelvi-ureteric junction stenosis detected antenatally might benefit from pyeloplasty?

@entity1 @entity227 @entity177
INTRODUCTION: Until recently, renogram, performed in @entity1 with pelvi-ureteric junction stenosis detected antenatally, has not been able to predict the probability of function improvement after surgery or the risk of function deterioration in case of conservative attitude. Recently, Schlotmann et al. have suggested that cortical transit might have this predictive role. The aim of this study, focused on those kidneys with severely impaired cortical transit, was to verify this statement. METHODS: All renograms performed in @entity1 during a 3-year period (n=729) were retrospectively reviewed and 19 pediatric @entity1 were selected based on an antenatally detected unilateral pelvi-ureteric junction syndrome, the existence of at least two renograms during the follow-up and a severe cortical transit @entity227 . Twenty-six pairs of data could be analyzed and allowed comparing preoperative and postoperative @entity177 ( @entity177 ), and the @entity177 changes during the conservative management. RESULTS: Among the 16 @entity1 who underwent pyeloplasty, 10 showed a significant @entity177 improvement. Among the 10 @entity1 with conservative follow-up, four showed a significant @entity177 . CONCLUSION: Severely impaired cortical transit seems to be a valuable marker of those @entity1 who could benefit from a pyeloplasty, either because of the high probability of postoperative @entity177 improvement, or because of @entity177 in case of an conservative approach. However, a normal cortical transit, as defined in this study, does not exclude the risk of @entity177 . Alternatively, the design of this study does not allow excluding the fact that @entity177 might improve after pyeloplasty despite a normal cortical transit.
