Find in Library

The present study was carried out by evaluate the safety and effectiveness of the selective conservative manage-ment of antenatally detected unilateral pelviureteric junc-tion 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 manage-ment 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 ultra-sonography (US). Prophylactic antibiotics were not pres-cribed 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 chemo-prophylaxis.