Abstract
Background: The distension of the pelvis and calyces of the kidney due to the obstruction and stasis of urinary flow or Hydronephrosis, caused by a lesion in the upper or lower urinary tract. The giant hydronephrosis (GH) is a rare entity and its etiologies are varied. Most reported cases of GH occur in infants and children, and are congenital in origin.
Objectives: To formulate and validate a strategic approach for the treatment of giant hydronephrosis (GH) based upon anatomical and functional status of renal units in adults.
Patients and Methods: We present a retrospective review about 24 cases of GH managed between February 2001 and February 2010. Epidemiologic data, radiological investigations, therapeutic indications, preoperative findings and follow-up were reviewed. Therapeutic indications were based upon functional status of GH.
Results: The age of the patients ranged from 19 to 61 years. Ten patients were males and 14 were females. IVU revealed non-visualized unit of the affected side in 4 patients. The quantity of urine drained was between 1.1 litres and 3.5 litres. Seven patients were subjected to nephrectomy. Eight patients underwent reduction pyeloplasty. Nine patients were treated for urolithiasis. Follow-up was in the range of 9 to 73 months (mean = 32 months). Four patients had chronic renal failure requiring hemodialysis and one patient presented with recurrent pyelonephritis.
Conclusions: In very poorly functioning unit, nephrectomy is the procedure of choice. In salvageable unit, anatomical configuration should dictate the type of reconstructive procedur
Implication for health policy/practice/research/medical education:
This paper can be useful in approach to management of giant hydronephrosis which is a rare entity.
Please cite this paper as:
Sataa S, Kerim C, Sami BR, Nizar D, Rochdi E, Nidhameddine E, et al. Giant hydronephrosis in adult: What is the best approach? Retrospective analysis of 24 cases. Nephro-Urol Mon. 2011;3(3):177-181.
Article history:
Received: 16 Dec 2010
Revised: 25 Jan 2011
Accepted: 13 Feb 2011
Keywords
Kidney Adult Hydronephrosis Pelvi-ureteric Junction Obstruction Nephrectomy
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