Pelvi-Ureteric Junction Obstruction Among Libyan Children in Misurata Medical Center: A Retrospective Study
Objectives. The objective of our study is finding the mode of presentations and treatments for primary pelvi-ureteric junction (PUJ) obstruction in children. Methods. This is a retrospective descriptive study, looking at children with PUJ Obstruction carried out at Misurata Medical Center (department of urology) from June 2013 to June 2018. All data were obtained from patient's records. The inclusion criteria were patients between the age of 2 months up to 13 years old diagnosed with PUJ obstruction using ultrasound and/or C.T. Uroscan. From each patient record, we looked at age, urine analysis, urine culture and sensitivity, urea and creatinine levels, ultrasound and at last the type of surgical intervention. The total number of cases obtained from the registry is 25 cases, and we were able to review the patient’s records of all these cases. Results. Out of the 25 cases, 15 cases (60%) were male and 10 cases (40%) were female. The age mean is 4.6. The incidence of the obstruction was more common on the left side, accounted for 13 (52%) cases, while 11 cases had the obstruction on the right side (44%), only one case presented with bilateral obstruction (4%). all cases managed surgically, 22 (88%) cases underwent Anderson -Hynes pyeloplasty, and 3 (12%) cases had nephrectomy. The average hospital stays range from 5-7 days. During the follow- up period which was 6 months after discharge, the DJ stent was removed in week 8, and control ultrasound and renal function test performed regularly during this period. All patients recovered uneventfully except for 3 patients who developed prolonged extravasation of urine in the third week after the operation, and just one case complicated with surgical site infection. Out of 22 cases that underwent pyeloplasty, 20 cases showed significant improvement in their renal parameters. Conclusion. PUJ obstruction is more common in males. The clinical presentation varies between patients. Post-operative recovery of renal function is achieved in the majority of cases using Anderson-hyens pyeloplasty.
Copyright (c) 2021 Salem Swieb, Omar Alhaddad
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