IMP: Left PCN is done smoothly Voiding Cystourethrogram (VCUG) IMP: No vesico-ureteral reflux (VUR) Antegrade Pyelogram
(AP) IMP: (1) Left UPJ stenosis with severe degree hydronephrosis. (2) s/p left PCN insertion. 24 hours Creatinine Clearance Rate PCN. Left kidney Voiding. Right kidney
CCr(PCN, Left) : CCr (Voiding, Right) = [23mg/dl*829ml] : [15ng/dl*1145ml] = 52.6% : 47.4% Comprehensive Renal Function Test (CRFT) Left T1/2 = 23.1 min
Right T1/2 = 4.0 min Left Uptake = 51.7% Right Uptake = 48.3% IMP: (1) Obstruction of left collecting system. (2) No obstruction of right collecting system. Laparoscopic Dismembered Pyeloplasty + Double J Stenting
Discussion Ureteropelvic Junction Stenosis Ureteropelvic Junction Stenosis The
most common obstructive lesion in childhood Incidence: 1 in 500 live births 60% of on the left side Bilateral in only 10% of cases
Male : Female = 2:1 Clinical Manifestations Hydronephrosis Abdominal, Palpable
flank, or back pain renal mass Pyelonephritis Failure or UTI
to thrive, vomiting, diarrhea Etiology of Antenatal Hydronephrosis Etiology of UPJ Stenosis Congenital
stenosis Intrinsic stenosis Extrinsic: accessory artery to kidney Postnatal evaluation of unilateral fetal hydronephrosis RPD: Renal pelvic diameter
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