EVALUATING ULTRASOUND-BASED SCORING SYSTEM FOR INDICATION OF PYELOPLASTY IN INFANTS WITH URETEROPELVIC JUNCTION OBSTRUCTION-LIKE HYDRONEPHROSIS

Abstract

Objectives: Previous scoring systems have used renal scan parameters to assess severity of ureteropelvic junction obstruction-like hydronephrosis. However the availability in different facilities and credibility of this technology is limited due to protocol variation across centers and renogram limitations, especially for infant care. Therefore, the study aimed to predict the likelihood of pyeloplasty in infants with ureteropelvic junction obstruction-like hydronephrosis by the Pyeloplasty Prediction Score (PPS).

Methods: Retrospective case series of infants with ureteropelvic junction obstruction-like hydronephrosis.

Results: Amongs 337 patients, 260 (77.2%) were male, 270 (80.1%) had left ureteropelvic junction obstruction-like hydronephrosis, and 79 (23.4%) had a pyeloplasty. The median age at baseline was 3 months. The PPS system was highly accurate in determining patients who would undergo pyeloplasty using baseline ultrasound measurements (AUC: 0.958). PPS of 8 was found to have a sensitivity of 88.6% and specificity of 90.3%, respectively. PPS of 8 was associated with a likelihood ratio of 9.1.

Conclusion: Patients with a PPS of eight or higher were nine times more likely to undergo pyeloplasty.

Keywords: ureteropelvic junction obstruction; pyeloplasty; ultrasonography score