Diagnosis and management of the hydronephrotic type of multicystic dysplastic kidney. Use of antegrade pyelography.

The distinction between the hydronephrotic type of multicystic kidney disease and ureteropelvic junction obstruction can be difficult using conventional imaging techniques. Antegrade pyelography with or without percutaneous nephrostomy may be performed to confirm the diagnosis of complete ureteral obstruction and to guide management decisions. One may elect either immediate nephrectomy or observation after performance of this diagnostic procedure. Reconstruction of nonsalvageable kidneys is avoided.