These 268 patients had chronic ureteral obstruction and MAG3 renography performed before and after intervention to relieve the obstruction. They divided patients into 4 groups, based on the preoperative relative renal function (RRF): normal (43-57%), mild (29-42%), moderate (15-28%), severe (<15%).
Surprisingly, their results showed that none of the groups had a significant increase in postoperative RRF. In fact, patients with mildly impaired preoperative RRF had significant worsening of RRF after intervention. The other 3 groups, normal, moderate, and severe RRF, had no significant change in RRF postoperatively. Most patients (73%) did not switch from one group to another following intervention to relieve the obstruction.
During the presentation, Dr. Smith discussed that intervention should be done to maintain existing renal function and for symptomatic relief as opposed to aiming for significant increases in renal function. There are implications to this study, such as counseling patients about their expectations in improvement of renal function and discussing the possibility of foregoing intervention for patients that may not benefit.
Presented by: Daron Smith, MA, BMBCh, MD, FRCS(Urol), Institute of Urology, University College London Hospitals, United Kingdom
Written by Rajiv Karani, Associate Research Fellow, Department of Urology, University of California, Irvine, at the 37th World Congress of Endourology (WCE) – October 29th-November 2nd, Abu Dhabi, United Arab Emirates