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Minki Baek, Dong Wan Sohn1, Kyung Jin Oh2, Tack Lee3
, Hyuk Soo Chang4, Sang Won Han5, Sang Don Lee6; The Korean Society of Pediatric Urology
, Hyuk Soo Chang4, Sang Won Han5, Sang Don Lee6; The Korean Society of Pediatric UrologyAbstract
Purpose
To evaluate practice patterns for pediatric hydronephrosis of Korean urologists practicing at secondary or university hospitals.
Materials and Methods
The subjects were asked to complete questionnaires sent by postal mail or e-mail that explored practicing diagnostic and therapeutic strategies in the management of pediatric hydronephrosis and ureteropelvic junction obstruction. The questionnaires of those responding were analyzed according to whether the respondent practiced at a secondary or university hospital, how long they had been urologists, and whether they specialized in pediatric urology or other specific field of urology.
Results
Of the 354 questionnaires sent, 97 were returned (response rate 27.4%). Voiding cystourethrography was not routinely recommended by 95.7% of respondents, and diuretic renal scanning was considered necessary for postnatal evaluation of prenatal hydronephrosis by 78.5%. In addition, 72.2% of these doctors did not routinely recommend antibiotic prophylaxis. Follow-up ultrasonography was recommended at 3 to 6 months (61.1%), and follow-up diuretic renal scanning was recommended at 3 to 6 months (38.6%) or 6 to 12 months (32.7%). The reported length of time it took to deem an operation as a success was 3 to 6 months (49.5% and 60.7%) and within 3 months (34.1% and 19.1%) by ultrasonography and diuretic renal scanning, respectively.
Conclusions
This survey documented a certain degree of variability among Korean urologists concerning standard practices of the assessment, follow-up, and treatment for pediatric hydronephrosis. Results from this survey might contribute useful data for establishing proper guidelines for the management of pediatric hydronephrosis.
Figures and Tables
Fig. 1
The number of mean pediatric urology patients per month (A), proportion or pediatric patients (B), and the proportion of the pediatric hydronephrosis patients (C). 2nd: secondary hospital, Univ: university hospital, NPU: non-pediatric urologist, PU: pediatric urologist.
Fig. 2
Assessment method of fetal hydronephrosis (A) and timing of the first postnatal ultrasonography (B). SFU: Society for Fetal Urology, AP: anteroposterior, 2nd: secondary hospital, Univ: university hospital, NPU: non-pediatric urologist, PU: pediatric urologist.
Fig. 3
Voiding cystourethrography (A, B) and diuretic renal scanning (C, D) for work-up of fetal hydronephrosis. VCUG: voiding cystourethrography., 2nd: secondary hospital, Univ: university hospital, NPU: non-pediatric urologist, PU: pediatric urologist.
Fig. 4
Follow-up for fetal hydronephrosis. 2nd: secondary hospital, Univ: university hospital, NPU: non-pediatric urologist, PU: pediatric urologist.
Fig. 5
Urinary diversion during pyeloplasty. 2nd: secondary hospital, Univ: university hospital, NPU: non-pediatric urologist, PU: pediatric urologist, PCN: percutaneous nephrostomy.
Fig. 6
Operation for bilateral ureteropelvic junction obstruction. UPJO: ureteropelvic junction obstruction, 2nd: secondary hospital, Univ: university hospital, NPU: non-pediatric urologist, PU: pediatric urologist, postop.: postoperative.
Fig. 7
Follow-up imaging study after pyeloplasty. postop.: postoperative, 2nd: secondary hospital, Univ: university hospital, NPU: non-pediatric urologist, PU: pediatric urologist.
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