R González1, C M Schimke. 1. Department of Pediatric Urology, Children's Hospital of Michigan, Detroit, USA.
Abstract
OBJECTIVES: To review the evaluation and management of the neonate and infant with prenatally detected hydronephrosis caused by a presumed ureteropelvic junction obstruction. METHODS: The literature is reviewed and the arguments in favor of expectant observation versus early operation are discussed. RESULTS: The meaning and severity of prenatally diagnosed hydronephrosis is determined after birth by evaluating: 1) the overall condition of the child; 2) the degree of dilatation on the ultrasonogram; 3) the differential renal function in the renogram and 4) the pattern of the excretory curve after furosemide in the renogram. CONCLUSION: It is understood that dilation per se does not mean obstruction but, if all other parameters indicate obstruction, we recommend early surgical treatment to prevent obstructive damage to the immature infant kidney and because better recovery of function is possible when surgery is done in the first year of life.
OBJECTIVES: To review the evaluation and management of the neonate and infant with prenatally detected hydronephrosis caused by a presumed ureteropelvic junction obstruction. METHODS: The literature is reviewed and the arguments in favor of expectant observation versus early operation are discussed. RESULTS: The meaning and severity of prenatally diagnosed hydronephrosis is determined after birth by evaluating: 1) the overall condition of the child; 2) the degree of dilatation on the ultrasonogram; 3) the differential renal function in the renogram and 4) the pattern of the excretory curve after furosemide in the renogram. CONCLUSION: It is understood that dilation per se does not mean obstruction but, if all other parameters indicate obstruction, we recommend early surgical treatment to prevent obstructive damage to the immature infant kidney and because better recovery of function is possible when surgery is done in the first year of life.