Letter Questions Furosemide Ultrasound as a Pyeloplasty Predictor in Children

A letter published in the African Journal of Urology challenges the conclusions of a study by Masoud and colleagues that evaluated post-furosemide ultrasonography as a predictor of the need for pyeloplasty in children with prenatally detected pelviureteric junction-like hydronephrosis. The letter, authored by Gyanendra R. Sharma and Pankaj N. Maheshwari, was published on 2 September 2026 as a Matters Arising contribution.

While the letter’s authors commend this effort, they state that several methodological concerns may affect how the study’s results should be interpreted.

Beyond critique, the letter proposes a simpler, injection-free alternative. This approach relies on comparing the anteroposterior diameter of the renal pelvis measured in the supine position with the same measurement taken in the prone position, avoiding the administration of furosemide altogether.

The authors also present a methodology that classifies drainage of the pelvicalyceal system as good, partial or poor based on ultrasonography findings, with the stated aim of guiding further management. The letter focuses on children with renal pelvis anteroposterior diameters of 10 to 20 millimetres, the range examined in the original work.

Subject of Research: Diagnostic imaging of pelvicalyceal dilatation in children and its role in guiding pyeloplasty decisions

Article Title: Letter to editor–Diagnostic value of post-furosemide ultrasonography in children with pelvicalyceal dilatation (renal pelvis APD 10–20 mm): a predictor of pyeloplasty indication and comparison with diuretic renal scintigraphy

Article References: Sharma, G. R., & Maheshwari, P. N. (2026). Letter to editor–Diagnostic value of post-furosemide ultrasonography in children with pelvicalyceal dilatation (renal pelvis APD 10–20 mm): a predictor of pyeloplasty indication and comparison with diuretic renal scintigraphy. African Journal of Urology, 32(1), Article 64. https://doi.org/10.1186/s12301-026-00611-4

Image Credits: AI Generated

DOI: 10.1186/s12301-026-00611-4

Keywords: hydronephrosis, pyeloplasty, ultrasonography, furosemide, diuretic renal scintigraphy, pelviureteric junction obstruction, pediatric urology, renal pelvis APD, African Journal of Urology, letter to the editor, Letter, editor