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August 5, 1968

Hydronephrosis in Infants and Children: II. Surgical Management and Results

Author Affiliations

From the Department of Urology, College of Physicians and Surgeons, Columbia University, Columbia-Presbyterian Medical Center, and Babies Hospital, New York.

JAMA. 1968;205(6):327-332. doi:10.1001/jama.1968.03140320021006

From 1935 through 1965, 91 pyeloplasties and 45 nephrectomies were performed upon 126 infants or children with hydronephroses. In 27, nephrostomy was done before nephrectomy or pyeloplasty. Several children underwent unilateral nephrectomy and pyeloplasty on the opposite kidney; a few had bilateral pyeloplasties. Of the 126 children who underwent surgery for hydronephrosis, a total of 184 surgical procedures was necessary to excise or correct the hydronephrosis, as well as concomitant urological anomalies. "Splinting" catheters and nephrostomy or pyelostomy drainage tubes were used in almost all our pyeloplasties. The results of pyeloplasty have been good in children with grade 1 (mild) and grade 2 (moderate) hydronephrosis, and only fair in those with grade 3 (severe) hydronephrosis. Complications and failures occurred principally from 1935 to 1945. No surgical deaths, after pyeloplasty, ensued in the entire series.