Validity of ultrasonography for postoperative monitoring in pediatric urology.

Purpose: We studied the validity of ultrasonography for short-term followup in pediatric urology.
Materials and Methods: The study group comprised 137 children (187 urinary tracts) undergoing surgery at our hospital for congenital urological pathology between February 1982 and July 1992. The study protocol designed to evaluate urinary tract dilation postoperatively and monitor its progress, included ultrasound at discharge from the hospital, and repeat ultrasound between days 20 and 30, and days 45 and 60. Diuretic renography or excretory urography was indicated when urinary tract dilatation showed no signs of regressing or had increased on 2 consecutive evaluations. Ultrasound of the urinary tract was done to evaluate variations in the grade of dilatation of the pelves, calices, infundibula and ureters, and grade of hydronephrosis.
Results: Variations in the grade of dilatation of the infundibula and ureters were early sensitive indicators of the absence of obstruction. Using this protocol only 15 of the 187 urinary tracts (8%) corrected surgically needed further evaluation for suspected iatrogenic stenosis, including 3 with obstruction that required reoperation. No other cases of obstruction were detected during long-term followup.
Conclusions: A series of sonographic evaluations performed within a short period and the greater significance attributed to more specific parameters, such as grade of dilatation of the infundibula and ureters, make ultrasound a valid means of monitoring urological cases postoperatively.