Objective To analyze the factors associated with the outcome of pyeloplasty in term of renal function and morphology improvement in children with unilateral ureteropelvic junction obstruction,in order to provide clinical evidence for the treatment of hydronephrosis in children.Methods Clinical data of 174 children who underwent unilateral dismembered pyeloplasty from January 2009 to June 2014 were retrospectively studied.Differential changes in renal function and renal morphology after pyeloplasty were assessed by serial renal scan and ultrasound.On the basis of preoperative split DRF,these patients were divided into three groups:group Ⅰ with DRF ≥40％ (n =99),group Ⅱ with DRF 30％-40％ (n =29) and group Ⅲwith DRF ＜ 30％ (n =46).According to their age at surgery,the children were divided into four groups,including group A aged 1-3 months (n =52),group B aged 3 months-3 years (n =44),groupCaged3-6years (n =37),and group D aged more than 6 years (n =41).Results Inall 174 children,postoperative complication occurred in 7 cases,including urinary tract infection in 6 cases and renal atrophy in 1 case.A significant improvement of both function and morphology was confirmed in most patients (P ＜ 0.01).Patients in group Ⅰ showed stable renal function after operation(DRF 48.46％ ±4.80％ vs.50.78％ ± 5.45％,P ＜ 0.01),of them who underwent pyeloplasty at 1-3 months of age showed the best obvious recovery of renal morphology.Renal function of patients in group Ⅱ recovered obviously and most of them reached to the initial values (DRF 35.18％ ± 2.95％ vs.43.91％ ± 6.89％,P ＜ 0.01).While renal function of patients in group Ⅲ recovered significantly after surgery,most of them failed to restore the initial values(DRF 20.70％ ± 6.90％ vs.33.78％ ± 12.49％,P ＜ 0.01),and among them,the aged 1-3 months group possessed the best recovery.Moreover,the morphological improvement was similar to the functional improvement.The time for hydronephrosis recovered to less than Grade 2 of Society for Fetal Urology(SFU)was 6,24 and over 24 months respectively in group Ⅰ,Ⅱ and Ⅲll,and the renal morphology gradually improved with the increasing duration of follow-up.Conclusions The renal function and morphology of most patients improved significantly after pyeloplasty.Recovery of renal function and morphology after surgery was significantly correlated with the preoperative DRF.Early surgical intervention may improve the function and morphology recovery of the involved renal unit.

Objective To evaluate the outcomes of hypospadias surgery relating to penile appearance,social adaptation and psychological condition in children and adolescents.Methods 85 patients who underwent urethroplasty (2003-2013) in our department,hypospadias was distal and proximal in 50 and 35 patients;27 of them with complications.All of patients were interviewed by a urologist in our department with self-designed questionnaire,Achenlach Child Behavior Checklist (CBCL) and Pediatric Penile Perception Score(PPPS).Mean age was 9.97 years and median follow-up of 6.4 years.Results 67 (77.0％) patients were satisfied with their penile appearance.Patients with complications or more surgical times were more likely to improve the appearance by operation again.The PPPS data showed that patients themselves were most satisfied with the appearance of the genitals than the parents of boys or the urologists.Patients with poor genital self-perception,lower satisfaction of their penile appearance or severer types of hypospadias,they were more likely to suffer from psychosocial problems(P ＜ 0.05).The higher knowledge of hypospadias predicted the more positive penile self-perception,and the better follow-up rate(P ＜ 0.05).CBCL survey data revealed that some patients had few hobbies,while their social situation and learning ability were normal.Conclusions Boys with corrected hypospadias appeared to experience normal social and learning ability.The type of hypospadias,surgical times,complications and the penile appearance were important factors in assessing the outcome of hypospadias.