Téma: 

Hydronephrosis in childhood

Juraj Svitač

Hydronephrosis is defined as a morphological finding of the abnormal dilatation of the renal collecting system, in some cases together with the reduction of the renal parenchyma. Introduction of the prenatal and postnatal ultrasound screening 30 years ago led to the large increase of the amount of asymptomatic newborns with this diagnosis. In the past, hydronephrosis was diagnosed only as a result of the diagnostic process initiated by symptoms (pain, colic, sepsis). On the contrary accepted and used treatment guidelines screening findings of hydronephrosis without symptomatology led to serious doubts about choosing the right treatment. Generally, the screening discovers foetal abnormalities in 0.5 % of gravidities, 25 - 50 % of them affecting the urogenital system. 35 - 50 % of prenatal diagnosed dilatations are not confirmed after birth. Even in the case of postnatal persisting hydronephrosis, this usually disappears by the age of one year spontaneously. The above stated data support the conservative management of hydronephrosis in infants. The operation should be indicated only in cases with proven obstruction. In this article, current opinions in diagnostics and management of hydronephrosis in children are discussed.

Ročník 2007  Témy časopisu Clinical urology 1 / 2007

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