Clinical Outcome of Ureteropelvic Junction Obstruction in the Pediatric and Adult Population

소아와 성인에서의 신우요관이행부폐색의 임상적 경과

Background: A ureteropelvic junction (UPJ) obstruction is a congenital anomaly commonly afflicting the pediatric population. However, it occurs more frequently in adults than is generally appreciated. To assess their characteristics, we have here compared and analyzed the clinical manifestations, causes, and outcomes of UPJ obstruction found in children and adults. Materials and Methods: 102 patients (118 renal units) out of 182 patients (218 renal units), with diagnosed UPJ obstruction, were available for follow up. The follow-ups were retrospectively reviewed to determine the presenting symptoms, treatments, and clinical outcomes. Patients who were younger than 18 years of age were assigned to the pediatric group (44 patients), others the adult group (58 patents). Results: The majority of the patients presented with flank pain (pediatric group: 68%, adult group: 76%). The majority of patients underwent a pyeloplasty (pediatric group: 50.9%, adult group: 62.3%). And the major cause of the UPJ obstruction was an intrinsic stenosis (pediatric group: 53%, adult group: 56%). Conclusion: The prevalence of bilateral UPJ obstruction in adults is evidently less prevalent than in pediatrics, and despite the late diagnosis, the surgical outcome is similar. A further investigation of UPJ obstruction will lead us to a more comprehensive understanding of the disease.

소아에 비해 성인에서 발생한 신우요관이행 부폐색의 두드러진 임상적 특징은 소아에 비해 양측성인 경우가 현저히 적었으며, 진단이 지연되었음에도 불구하고 수술 성공률은 소아에서와 비슷하였다. 향후 소아 및 성인의 신우요관이행부폐색 환자에 대한 광범위한 임상 통계가 이루어진다면 이 질환의 정확한 자연사를 알 수 있으며, 또한 성인에서 발생한 이 질환이 태아나 소아 때부터의 질환인지, 아니면 성인이 되어 발생한 질환인지 확인할 수 있을 것이다.