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LETTER TO EDITOR
Year : 2007  |  Volume : 23  |  Issue : 3  |  Page : 330
 

Authors' reply


Department of Urology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India

Correspondence Address:
Rakesh Kapoor
Department of Urology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-1591.33740

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How to cite this article:
Kapoor R, Singh P. Authors' reply. Indian J Urol 2007;23:330

How to cite this URL:
Kapoor R, Singh P. Authors' reply. Indian J Urol [serial online] 2007 [cited 2019 Sep 20];23:330. Available from: http://www.indianjurol.com/text.asp?2007/23/3/330/33740


Dear Sir,

We greatly appreciate your interest in paper and your thoughtful queries. [1] It is true that GFR measured by radionuclide scans is not the best method (in comparison to direct assessment of creatinine clearance of renal moiety through percutaneous nephrostomy), however, in clinical practice it is the best noninvasive method to calculate GFR. Therefore most studies in the literature have taken it into consideration for treatment planning.

Improvement in function is one of the objective criteria we used to asses the success of the procedure as these are poorly functioning moieties and t on renal scan is difficult to comment in this situation . However, we agree with you that t could have been used as a marker of success if possible.

Definition of poorly functioning kidneys (GFR <25 ml/min) used is appropriate and in accordance with the existing literature and GFR <10 ml/min or less than 15% relative function is currently recommended as the limit to consider nephrectomy in most series. [2]

Patient who underwent laparoscopic pyeloplasty in renal moiety with zero per cent function is asymptomatic till last follow-up, however, has not undergone renal scan in follow-up.

We feel that these patients with poorly functioning kidneys are best followed up with renal scan, as these moieties are not visualized on intravenous urography in our experience and intravenous urography is associated with the risk of radiation.

 
   References Top

1.Singh P, Kapoor R, Suri A, Singh KJ, Mandhani A, Dubey D, et al. Comparison of endopyelotomy and laparoscopic pyeloplasty for poorly functioning kidneys with ureteropelvic junction obstruction. Indian J Urol 2007;23:9-12.  Back to cited text no. 1    
2.Ost MC, Kaye JD, Guttman MJ, Lee BR, Smith AD. Laparoscopic pyeloplasty versus antegrade endopyelotomy: Comparison in 100 patients and a new algorithm for the minimally invasive treatment of ureteropelvic junction obstruction. Urology 2005;66:47-51.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]




 

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