Hydronephrosis due to the obstruction of the urinary tract detected by the fetal echography and also detected soon after the birth

• Published in: Nihon Jinzo Gakkai shi Vol. 30; no. 11; pp. 1283 - 1292
• Main Authors: IITAKA, KIKUO, ISHIDATE, TAKEO, HOJO, MIDORI, SHIRAI, HIROYUKI, FUJINO, NOBUYUKI, ENDO, TADAO, SAKAI, TADASU
• Format: Journal Article
• Language: Japanese
• Published: Japan Japanese Society of Nephrology 01.11.1988
• Subjects: Female; Fetal Diseases - diagnosis; fetal echography; Humans; hydronephrosis; Hydronephrosis - congenital; Hydronephrosis - diagnosis; Hydronephrosis - etiology; Infant, Newborn; nephrostomy; Pregnancy; Prenatal Diagnosis; Ultrasonography; Ureteral Obstruction - complications; Ureteral Obstruction - congenital; Ureteral Obstruction - diagnosis; ureteropelvic junction; vesicoureteral junction
• ISSN: 0385-2385; 1884-0728
• DOI: 10.14842/jpnjnephrol1959.30.1283

The twelve children with hydronephrosis have been followed for the mean period of 2 years and 8 months. Their lesions were detected by the fetal echography in 8 (group A) and also detected within 4 months after their birth in 4 (group B). In group A the lesions were bilateral in 5 and unilateral in 3 and were due to the obstruction at the ureteropelvic junction (UPJ) except for one baby with urethral obstruction who died at 5 days old, but he did not have the oligohydramnios. The nephrostomy tube was inserted in 2 patients with severe unilateral hydronephrosis, but the nephrestomy was performed at 5 months old due to the poor urinary output and the urinary tract infection in one and the nephrostomy has been successfully continued for about 2 years in one. The other 5 children have been followed conservatively and the spontaneous improvement of hydrone-phrosis was observed in 4 and the lesion was unchanged in one. Hydronephrosis was detected by the various reasons in group B and was due to the bilateral vesicoureteral obstruction in 2 and unilateral UPJ obstruction in 2. The ne-phrostomy tube was inserted in one with severe unilateral hydronehrosis due to the obstruction at the UPJ, but it was removed after 3 months when the passage of the con-trast medium was confirmed at the UPJ. Spontaneous improvement was also observed in the other 3 patients. Recently the increasing number of children with the congenital hydronephrosis have been detected during their intrauterine life by the fetal echography and also at their neonatal period. Severe congenital hydronephrosis due the obstruction of the urinary tract requires surgical treatments, but the spontaneous improvement of these lesions with con-servative treatments or the nephrostomy was observed in 9 of 12 patients in this study. These observations should be considered in the managements of the surgical correction of the congenital hydronephrosis due to the obstruction of the urinary tract.