Chirurgia per idronefrosi cronico

In response to a question : how to treat silent hydronefrosis (without pain) and a marked reduction in kidney function ?

AAGL-ENDO-EXCHANGE Digest - 7 Aug 2011 to 8 Aug 2011

Date: Mon, 8 Aug 2011 15:50:26 -0400

From: Philippe Koninckx and Anastasia Ussia <Gary_Frishman@BROWN.EDU>

Subject: Chronic hydronephrosis surgical management

In all cases seen with hydronephrosis until today (around 100): strategy has

been consistently the same

* insert a stent if possible

* dissect the ureter what will give the diagnosis of the cause of the

hydronephrosis ie generally endometriosis, rarely compression only. Anyway

this becomes apparent during dissection.

* during dissection decide whether excision of surrounding endometriosis is

sufficient or whether a resection anastomosis is necessary (a reimplantation

almost always is a secondary option after failure as published)

Since dissection of the ureter was not done, I would suggest repeat surgery.

The prognosis of the kidney function is difficult to predict since the duration

that the hydronephrosis existed is unknown.

Sincerely

Philippe Koninckx and Anastasia Ussia

Gruppo Italo Belga, Belgium and Italy

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