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ORIGINAL ARTICLE
Year : 2000  |  Volume : 17  |  Issue : 1  |  Page : 24-27

Antenatally detected pelviureteric junction obstruction: Safety of conservative management by our protocol


Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
D K Gupta
Department of Pediatric Surgery, All India Institue of Medical Sciences, New Delhi - 1 10 029
India
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Source of Support: None, Conflict of Interest: None


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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% 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 nuclear 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% or below during the mean follow-up period of 30 months. Only I 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.


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