engleski

Managing antenatal hydronephrosis: a ten year experience in a single center

Objective: Antenatal hydronephrosis (ANH) is the most common abnormal finding of the urinary tract detected by prenatal ultrasonography. However, the postnatal management of ANH is controversial. Aim of this study was to demonstrate postnatal investigations and treatment of infants with ANH in a single center during a 10 year period.Methods: We retrospectively analyzed the data of postnatal management of 124 children with ANH. All diagnoses were postnatally confirmed by ultrasonography. Diuretic and static scintigraphy and voiding cystourethorgraphy (VCUG) were performed according to set indications. Therapeutic decisions were made in consensus with urologists.Results: In the period between 2001 and 2011 we have seen 124 children with ANH (82 boys and 42 girls). The hydronephrosis was found to be bilateral in 45 children, and 79 children had unilateral hydronephrosis, which connotes 169 abnormal renal units (RU). We detected 47 (27.8%) RU with vesicoureteral reflux, 35 (20.7%) RU with ureteropelvic junction obstruction, 34 (20.1%) RU with non-obstructive hydronephrosis, 25 (14.8%) RU with non-obstructive/non-refluxing megaureter, 13 (7.7%) RU with ureterocele, 8 (4.7%) RU with posterior urethral valves, 5 (2.9%) RU with obstructing megaureter and 2 (1.2%) RU were multicystic dysplastic kidneys. Fifthy-four (31.9%) RU were treated surgically, and the rest were followed-up conservatively.Conclusions: Prognosis and treatment of ANH is largely dependent on the underlying etiology. Early postnatal elucidation of the cause of dilated collecting system is essential. In our study we found more than one third of postnatally confirmed ANH to be caused by obstructive lesions, followed by VUR. However, only one third of all cases required surgical treatment.

antenatal; hydronephrosis; children

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