The Ultrasonographic Follow up Results and the Prognosis of Prenatal Hydronephrosis

Kang, Yun Seog; Han, Sang Won; Choi, Seung Kang

Abstract

The diagnosis of hydronephrosis has been increasing in compared to other organs anomaly since the advent of the prenatal ultrasonography, and it is important to differentiate between physiologic and pathologic hydronephrosis. We retrospectively reviewed the follow up of the postnatal ultrasonography and tried to determine the course of prenatal hydronephrosis. The pyeloplasty was indicated 27.1% of patients, in where the diameter of renal pelvis ranged from 18 to 68 mm with a mean of 41 mm and all patients had severe calyceal dilatation. Normal group in which no obstruction pattern on DTPA renal scan were 55.9% and the diameter of renal pelvis ranged from 6 to 23 mm with a mean of 13 mm. The cases of normal, close observation and indicated pyeloplasty were less than 50% and in all cases of vesicoureteral reflux, revealed urinary tract infection. The study revealed that prenatal ultrasonography alone is inadequate in determining the consistent prognostic factors of prenatal hydronephrosis. However, we determined that Pyeloplasty indicated in cases with severe dilatation of calyx and severe renal pelvis dilation. In cases with urinary tract infection. regardless of calyceal dilation and in cases with severe calyceal dilatation, voiding cystourethrogram should be performed to rule out vesicoureteral reflux. In the cases with mild to moderate dilatation, renal scan indicated to exclude a possible urinary tract obstruction. Minimal calyceal dilation can be regarded as free of urinary tract obstruction.