D K Gupta All Institute of Medical Sciences, New Delhi India
Source of Support: None, Conflict of Interest: None
The present study was carried out by evaluate the safety and effectiveness of the selective conservative management of antenatally detected unilateral pelviureteric junction obstruction (ADPUJ) in children who were diagnosed to have unequivocal obstruction upon DTPA renograms performed at 6 weeks of age. The study comprised of 28 patients with ADPUJ. The selective conservative management was applied to the patients with unilateral ADPUJ who were asymptomatic, had split renal function (SRF) above 40 percent and had the anterior posterior diameter of the pelvis less than 20 mm at 6 weeks of life. 20 of the 28 patients fulfilled the above criteria and were followed up at 3-monthly intervals with unclear renograms and ultrasonography (US). Prophylactic antibiotics were not prescribed to these patients. The remaining 8 patients underwent pyeloplasty. None of the patients followed up without surgical intervention deteriorated enough to the SRF of 40 percent or below during the mean follow-up period of 30 months. Only 1 of these 20 patients had an episode of urinary tract infection. In conclusion, unilateral ADPUJ managed by selective conservative treatment is safe and these patients do not require any antibiotic chemoprophylaxis.