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Cureus 2021 May 8;13(5):e14904. Epub 2021 May 8.

Department of Urology, San Fernando General Hospital, San Fernando, TTO.

This case represents an even rarer presentation of ureteropelvic junction obstruction (UPJO), that of a spontaneous life-threatening hemorrhage into the renal pelvis of a patient with previously unknown UPJO. Unique to this patient was the emergent nature of the presentation, requiring life-saving surgery. A review of the literature follows a discussion of the case. Read More

Hinyokika Kiyo 2021 Apr;67(4):141-145

The Department of Urology, Ijinkai Takeda General Hospital.

A pathologic kidney with hydronephrosis is prone to rupture after minor trauma to the renal pelvis ; however, it is controversial whether drainage, such as nephrostomy and ureteral stenting, should be performed in this setting. Herein we report traumatic rupture of the renal pelvis in 2 patients with ureteropelvic junction stenosis at two centers. Case 1 : A 15-year-old boy sustained a blunt injury on his left back while playing football. Read More

J Urol 2021 Jun 8:101097JU0000000000001899. Epub 2021 Jun 8.

Pediatric Nephrourology Division, Department of Pediatrics, National Institute of Science and Technology of Molecular Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.

Purpose: The aim of this study was to evaluate the performance of the new classification of urinary tract dilatation (UTD) to predict long-term clinical outcomes in infants with isolated antenatal hydronephrosis (AHN).

Patients And Methods: Between 1989 and 2019, 447 infants diagnosed with isolated severe AHN and were prospectively followed. The main predictive variable for the analysis was the new UTD classification system. Read More

J Laparoendosc Adv Surg Tech A 2021 May 27. Epub 2021 May 27.

Division of Pediatric Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China.

Success rate of laparoscopic pyeloplasty for ureteropelvic junction obstruction (UPJO) in children is comparable with open pyeloplasty. Prolonged ileus and injury to adjacent viscera more often occurred in transperitoneal approach; however, longer operation time is noted in retroperitoneal approach. This study presented a hybrid retroperitoneoscopic pyeloplasty (HRP), for congenital UPJO in infants weighing <10 kg. Read More

Urol Case Rep 2021 Jul 7;37:101705. Epub 2021 May 7.

Department of Pediatric Urology, Augusta University, 1446 Harper St. Augusta, GA, 30912, USA.

Ureteropelvic junction obstruction (UPJO) is the most common cause of urinary tract obstruction in pediatric patients. Debates in management include ureteral stent versus nephrostomy tube placement prior to surgical correction if intervention is warranted. We present a female patient with left UPJO, diagnosed at 15-years-old, treated with ureteral stent placement. Read More

Urology 2021 May 22. Epub 2021 May 22.

Division of Urology, University of São Paulo Medical School, São Paulo, Brazil; Hospital Moriah, São Paulo, Brazil. Electronic address:

Objectives: To systematically summarize the available evidence concerning the impact of pyeloplasty on symptoms and differential renal function (DRF) in adults with unilateral UPJO in poorly functioning kidneys (PFKs), and to identify potential predictors of kidney function recovery that could help clinicians select candidates for pyeloplasty.

Methods: A literature search (MEDLINE, Embase, Google Scholar, Scopus, ClinicalTrials.gov, and the WHO Clinical Trials Registry) and systematic review were performed up to September 2020 according to the PRISMA guidelines. Read More

Can Urol Assoc J 2021 May 11. Epub 2021 May 11.

Introduction: Minimally invasive pyeloplasty (MIP) for correction of ureteropelvic junction (UPJ) obstruction in children has significantly improved the postoperative management of these patients. In this study, we sought to examine the factors associated with early discharge (≤24 hours) in children that underwent robotic-assisted laparoscopic pyeloplasty (RALP).

Methods: We performed a retrospective chart review of all children who underwent RALP from 2012 to 2018 in our center. Read More

IJU Case Rep 2021 May 1;4(3):155-158. Epub 2021 Mar 1.

Department of Urology Tokai University School of Medicine Isehara Kanagawa Japan.

Introduction: Ureteropelvic junction obstruction associated with ureteral duplication is rare, with prevalence reported to be around 2-7%. Ureteropelvic junction obstruction of the lower pole with both complete and incomplete duplex systems is a common cause of obstruction. Here, we report a case of ureteropelvic junction obstruction associated with incomplete ureteral duplication of the solitary kidney successfully treated by pyeloureterostomy. Read More

Transl Androl Urol 2021 Apr;10(4):1792-1796

Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China.

An incomplete duplex kidney combined with ureteropelvic junction obstruction is a rare entity, and the surgical management strategy is highly individualized according to the anatomic variability. Currently, there is no literature report of the specific reconstructive method for the condition when obstruction occurs in both the upper and lower units of the duplex kidney. In this case report, a 60-year-old female with a right solitary kidney was admitted to our hospital. Read More

BMC Urol 2021 May 6;21(1):77. Epub 2021 May 6.

Urology and Lithotripsy Center, Peking University People's Hospital, Peking University, 133 Fuchengmen Inner Street, Xicheng District, Beijing, 100034, People's Republic of China.

Purpose: To compare the effects of two different methods of laparoscopic pyeloplasty for the treatment of crossing vessels.

Methods: From January 2016 to August 2019, 33 patients with ureteropelvic junction obstruction (UPJO) underwent laparoscopic pyeloplasty at our center, including 21 men and 12 women, ranging from 14 to 66 years of age. There were 20 and 13 cases on the left and right sides, respectively. Read More

Int Urol Nephrol 2021 May 4. Epub 2021 May 4.

Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA.

Purpose: Studies based on administrative databases show that infant pyeloplasty is associated with minority race/ethnicity but lack clinical data that may influence treatment. Our objective was to identify clinical and demographic factors associated with pyeloplasty in infants from three large tertiary centers.

Methods: We reviewed infants with unilateral Society for Fetal Urology (SFU) grade 3-4 hydronephrosis seen at three tertiary centers from 2/1/2018 to 9/30/2019. Read More

J Clin Med 2021 Apr 2;10(7). Epub 2021 Apr 2.

Core Unit Proteomics, Hannover Medical School, Institute of Toxicology, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany.

Congenital anomalies of the urinary tract, and particularly of obstructive nephropathy such as ureteropelvic junction obstruction (UPJO) in infants, can later lead to chronic kidney disease and hypertension. Fundamental questions regarding underlying mechanisms remain unanswered. The aim of the present study was to quantitate the systemic amino acids metabolome in 21 UPJO infants requiring surgery (Group A) and 21 UPJO infants under conservative treatment (Group B). Read More

J Laparoendosc Adv Surg Tech A 2021 May 26;31(5):594-597. Epub 2021 Apr 26.

Pediatric Surgery Unit, Department of Translational Medical Science, University of Naples "Federico II," Naples, Italy.

The development of integrated multimedia operating rooms has made possible to record surgical procedures mainly in minimally invasive surgery (MIS) and robotic surgery. This modality of video storage allows the trainees to study surgical procedures based on video analysis. The aim of this study is to compare two learning methods of surgical procedures, operative textbooks and video-based coaching, in a group of 10 pediatric surgery trainees. Read More

Turk J Med Sci 2021 Apr 26. Epub 2021 Apr 26.

Background And Aim: The criteria for surgical management of ureteropelvic junction obstruction are not well-defined, and there is a risk for loss of renal function before the operation. In this context, certain changes in contralateral kidney had been investigated in order to increase the sensitivity of diagnosis. In this study we aimed to investigate whether contralateral transient minimal hydronephrosis (CTMH) can be considered as an ?early alarm? sign for worsening of the affected kidney in infants with hydronephrosis. Read More

Int J Surg Case Rep 2021 May 16;82:105886. Epub 2021 Apr 16.

Department of Neonatal and Paediatric Intensive Care, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India.

Introduction: Minimally-invasive techniques offered by interventional radiology (IR) are really helpful in the management of challenging surgical cases. The current report highlights a series of four complex pediatric surgical cases which were successfully managed by specific image-guided techniques.

Case Presentation: The first two cases in the present report were infants. Read More

Urol Case Rep 2021 Sep 26;38:101665. Epub 2021 Mar 26.

Department of Urology, Saint-Joseph Hospital, Paris, France.

Forniceal rupture secondary to acute ureteral obstruction is relatively common. However, spontaneous ureteral rupture is less frequently encountered. Most reported cases were stone related, localized at the ureteropelvic junction and managed in a minimally invasive manner. Read More

Asian J Surg 2021 Apr 15. Epub 2021 Apr 15.

Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China. Electronic address:

The aim of this study was to evaluate the benefits and safety of transperitoneal and retroperitoneal pyeloplasty for ureteropelvic junction obstruction by a meta-analysis. We searched the databases including PubMed, Cochrane Library and Embase database from their inception to December 1st, 2020. Relevant literatures comparing retroperitoneal pyeloplasty with transperitoneal pyeloplasty were identified. Read More

J Pediatr Urol 2021 Mar 30. Epub 2021 Mar 30.

Urology Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.

Introduction And Objective: Anderson-Hynes dismembered pyeloplasty is considered the standard surgical treatment for ureteropelvic junction obstruction (UPJO). After pyeloplasty, stent drainage remains controversial. The commonly used stents are either an internal double-J (DJ) or an externalized pyeloureteral (PU) stents. Read More

J Pediatr Urol 2021 Mar 27. Epub 2021 Mar 27.

Pediatric Urology Unit, Division of Urology, Hospital das Clínicas, University of São Paulo Medical School, Brazil.

Introduction: Ureteropelvic junction obstruction (UPJO) particularly represents a challenge in regard to management, as not all hydronephrosis (HN) represent a kidney-damaging state. Urinary biomarkers have been proposed as noninvasive tools. Extracellular matrix (ECM) proteins are associated with tissue fibrosis in the setting of UPJO and is poorly explored. Read More

Transl Androl Urol 2021 Mar;10(3):1314-1320

Fifth Medical Centre of Chinese PLA General Hospital, Beijing, China.

Background: Three-dimensional (3D) image reconstruction technology is widely used in surgical operations for its intuitive visualization. Pyeloplasty requiresprecise cutting and suturing. The reconstruction technology can accurately determine the location and scope of the stenosis at the junction of the renal pelvis and ureter and the relationship with the surrounding vasculature. Read More

Urologiia 2021 Mar(1):90-94

Rostov Medical State University, Rostov-on-Don, Russia.

Purpose: In order to determine the role and significance of functional magnetic resonance urography (fMRU) in the diagnosis of ureteropelvic junction obstruction (UPJO), a comparative analysis of the results of fMRU and dynamic renal scintigraphy (DRS) was carried out.

Materials And Methods: From January 2017 to December 2019, fMRU and diuretic DRS were performed in 36 patients (mean age 89+/-63 months). Boys - 26 (72. Read More

Front Pediatr 2021 10;9:590865. Epub 2021 Mar 10.

Department of Pediatric Urology, Bayi Children's Hospital, Affiliated of the Seventh Medical Center of People's Liberation Army General Hospital, Beijing, China.

To present our primary experience of robotic-assisted laparoscopic pyeloplasty (RALP) for severe ureteropelvis junction obstruction (UPJO) infants under 3 months. We performed a retrospective study of 9 infants under 3 months who underwent RALP for severe UPJO between April 2017 and March 2019 in our center. The severe UPJO was defined as infants with severe hydronephrosis (Society of Fetal Urology grades III or IV, anteroposterior diameter >3 cm or split renal function <40% or T 1/2 >20 min) involving bilateral, solitary kidney, or contralateral renal hypoplasia UPJO at the same time. Read More

J Pediatr Urol 2021 Mar 9. Epub 2021 Mar 9.

Department of Medicine and Aging Sciences, "G. d'Annunzio" University, Chieti-Pescara, Italy; Department of Pediatric Surgery, "Spirito Santo" Hospital, Pescara, Italy.

Introduction: Vascular hitch (VH) gained an increasing success in treating ureteropelvic junction obstruction (UPJO) by crossing vessels (CV) in pediatrics.

Aims Of The Study: We aimed: (i) to compare laparoscopic VH versus laparoscopic dismembered pyeloplasty (DP) to treat UPJO by CV; (ii) to review possible amelioration given by a robot-assisted procedure.

Methods: Using defined search strategy, three investigators identified all studies on laparoscopic VH. Read More

J Pediatr Urol 2021 Feb 19. Epub 2021 Feb 19.

Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA; Division of Urology, Hospital of the University of Pennsylvania, Perelman Center for Advanced Care, 3400 Civic Center Blvd, 3rd Floor West Pavilion, Philadelphia, PA 19104, USA. Electronic address:

Introduction: Robot-assisted laparoscopic pyeloplasty (RALP) is a safe and efficacious option for repair of UPJO. We hypothesize that redo-RALP is technically more difficult but has comparable outcomes to primary RALP.

Methods: An IRB-approved single institutional registry was utilized to identify all patients undergoing primary or redo RALP from 2012 to 2019. Read More

Pediatr Dev Pathol 2021 Mar 22:10935266211002730. Epub 2021 Mar 22.

Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel.

Fetal urinoma is defined as an encapsulated accumulation of extravasated urine within the perirenal space or retroperitoneum. It is an uncommon finding in prenatal practice, and the vast majority of known cases are strongly associated with the existence of a urinary obstruction, such as posterior urethral valves, ureteropelvic junction obstruction, or ureterocele. We report a unique case of prenatally detected fetal bladder urinoma that occurred in the absence of an apparent obstructive uropathy, but was associated with extensive ischemic necrosis and calcifications of adjacent bladder wall, coexistent with signs of vascular supply decompensation. Read More

Arch Pediatr 2021 May 11;28(4):345-347. Epub 2021 Mar 11.

Department of Pediatric Surgery, University Hospital Center, Centre Hospitalier Universitaire d'Amiens, 1, rond-point Christian Cabrol, 80054 Amiens cedex 1, France. Electronic address:

Ureteropelvic junction obstruction (UPJO) in the upper pole of a complete duplicated renal system is extremely rare. We report a case that was diagnosed prenatally and we review 10 cases published in the literature. Diagnoses of adrenal hematoma and cystic neuroblastoma were suspected on prenatal ultrasound, based on the severity of dilatation and the difficulty of identifying the exact origin of this anomaly. Read More

Adv Exp Med Biol 2021 Mar 14. Epub 2021 Mar 14.

Department of Urology, Fourth Military Hospital, Wroclaw, Poland.

This study aims to define the quality of life (QoL) of patients who had undergone laparoscopic pyeloplasty due to ureteropelvic junction obstruction. The QoL was investigated in 26 patients after pyeloplasty, on average, at a 7.5-year follow-up. Read More

Urol Int 2021 Mar 10:1-5. Epub 2021 Mar 10.

Department of Urology, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany.

Introduction: Ureteropelvic junction obstruction (UPJO) and the simultaneous presence of kidney calyx stones represent a challenge for renal surgery. We present a novel technique for the simultaneous treatment of UPJO by robotic pyeloplasty in combination with the percutaneous endoscopic treatment of kidney calyx stones by flexible nephroscopy.

Patients And Methods: Between January 2018 and February 2020, 4 patients were diagnosed with UPJO and simultaneous pelvic or calyceal stones. Read More

World J Urol 2021 Mar 3. Epub 2021 Mar 3.

Division of Urology, Department of Surgery, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.

Objective: To describe the evolution of practice patterns for pediatric pyeloplasty and determine how these changes have impacted length of stay (LOS), reoperation rates and return emergency department (ER) visits.

Methods: We reviewed our pyeloplasty database from 2008 to 2020 at a quaternary pediatric referral center and we included children 0-18 years undergoing pyeloplasty. Variables captured included: age, sex, baseline and follow-up anteroposterior diameter (APD) and differential renal function (DRF). Read More

Int J Med Robot 2021 Jun 7;17(3):e2246. Epub 2021 Mar 7.

Department of Urology, Polytechnic University of Marche Region, "Ospedali Riuniti" Hospital, Ancona, Italy.

Objective(s): The incidence of urinary tract stone disease is steadily increasing in both adult and paediatric populations. This condition develops due to different factors: dietary or metabolic alterations, infection, and congenital anatomic malformations. Standard indications and treatments for children are analogous to the ones indicated for adults. Read More