Surgical management of pelviureteric junction obstruction in children at a tertiary Hospital in Addis Ababa, Ethiopia: A retrospective study

Abstract

Background: Pelviureteric junction obstruction (PUJO), which is characterized by impaired transport of urine from the renal pelvis to either ureter, is usually congenital in origin. This study aimed to describe the demographic distribution, management, and outcomes of paediatric PUJO at the main referral hospital in Ethiopia.

Methods: This was a retrospective study conducted at the Tikur Anbessa Specialized Hospital (TASH), a teaching hospital for the Addis Ababa University School of Medicine. Children operated on for PUJO between January 2012 and December 2016 were included in the analysis.

Results: There were 41 patients who were managed for PUJO at TASH during the period under study. Of the 33 included patients with available data, 30 (90.9%) had intrinsic PUJO. The remaining PUJO cases (n=3, 0.9%) were caused by aberrant vessels. Most patients (n=28 of 30, 93.3%) underwent open Anderson–Hynes pyeloplasty. Two patients (7%) underwent nephrectomy because of excessive parenchymal thinning. Of 31 cases of preoperative hydronephrosis, 26 (83.9 %) were documented to have improved after surgery, and 5 patients (16.1%) remained severely hydronephrotic.

Conclusions: The outcomes of PUJO management were generally favourable at TASH during the study period. Ultrasonographic investigation and follow-up are paramount, with emphasis on renal pelvic anteroposterior diameter measurements for patients with hydronephrosis, particularly in settings with relatively limited investigative capacity. Open Anderson–Hynes pyeloplasty is effective in our setting.