Comparison of urinary tract dilation and society for fetal urology classifications in predicting indication and success of pyeloplasty in ureteropelvic junction obstruction.

Objective: We aimed to compare the ability of the Urinary Tract Dilatation (UTD) and Society for Fetal Urology (SFU) classification systems to predict the need for treatment and the success of the applied treatment methods for ureteropelvic junction obstruction (UPJO) patients.

Patients and methods: The study included 239 patients who underwent follow-up, J stent insertion, or pyeloplasty due to UPJO between 2012 and 2022, with complete long-term follow-up data. During the follow-up period, failure was defined as fractional function decrease, lack of diuretic response, t1/2 increase, persistent symptoms, or an increase in hydronephrosis degree. Treatment modality and success were compared between UTD and SFU subgroups.

Results: In the study, a total of 239 patients were included, of whom 67 (28%) were female and 172 (72%) were male. The median age of the patients was 84 months (2-154.5 months), and the mean follow-up duration was 55 months (13-130 months). UPJO was observed in 99 (41.4%) patients in the right kidney and 140 (58.6%) patients in the left kidney. There were no statistically significant differences between the groups in terms of age, gender, side, and comorbidities (p = 0.165, p = 0.620, p = 0.441, and p = 0.768, respectively). We found a strong correlation between UTD and SFU classifications for patient treatment success, while a moderate correlation was observed for treatment failure (r = 0.816 and r = 0.575, respectively). Confirmed by both UTD and SFU classifications, conservative treatment was the appropriate choice for success in low-grade diseases, while pyeloplasty should be offered in high-grade diseases.

Conclusion: Both UTD and SFU classification systems show similar ability to predict the success rates regarding treatment methods for UPJO with a higher degree of confidence.