Diagnostic Accuracy of Renal Pelvic Dilatation for Detecting Surgically Managed Ureteropelvic Junction Obstruction

Purpose: In this study we evaluate the diagnostic accuracy of renal pelvic dilatation for detecting infants with prenatal hydronephrosis who will need surgical intervention for ureteropelvic junction obstruction during followup.Materials and Methods: Between 1999 and 2010, 371 newborns diagnosed with isolated prenatal hydronephrosis were prospectively followed. The main event of interest was the need for pyeloplasty. Diagnostic odds ratio, sensitivity, specificity and diagnostic accuracy (assessed by AUC) of fetal renal pelvic dilatation and postnatal renal pelvic dilatation were evaluated.Results: A total of 312 patients were included in the analysis and 25 (7.5%) infants underwent pyeloplasty. The diagnostic performance for detecting the need for pyeloplasty was excellent for all ultrasonography measurements. The AUC was 0.96 (95% CI 0.92–0.98) for fetal renal pelvic dilatation, 0.97 (95% CI 0.95–0.98) for postnatal renal pelvic dilatation and 0.95 (95% CI 0.92–0.97) for the Society for Fetal Urology gr...