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Urinary and Genital Disorders (Children)

Left Kidney Hydrpnephrosis

11/16/2009

Question:

My daughter was found with hydronephrosis of the left kidney when she was in her mothers womb, after her delivery we have show her to the doctor , they advise for MCU, and DTPA renogram, we did it and it showed a PUJ obstruction and they advised to get the child admitted for a operation ,but the chief doctor after seeing her DTPA scan advised that the kidney beans are good and she has to get her medical checkup every 6 months.but should try avoiding getting infections. She was taking Terapress and Gramoneg antibiotics in the first stages till the age of 2 years. Later when we scanned again the PUJ was still there and the enlarged area was still the same as it was in the beginning and it has not increased or decreased.

Now she is 4.5 years old and we have not checked up but she does not have any problem regarding anything.

What according to you is the correct way to guide me .

Answer:

Unfortunately, there is not enough information to provide a definitive answer. It sounds like she has significant hydronephrosis secondary to narrowing of the junction between the ureter and renal pelvis, which is a common disorder. Often prenatally-diagnosed hydronephrosis improves over time. However, if it is persistent and severe, then it is unlikely to resolve, and surgical correction should be considered. We generally make these decisions based on serial ultrasound studies, looking for improvement, and occasional renal scans (DTPA or MAG-3). If the hydronephrosis is not severe and the function in the kidney is good, then it is fine to monitor it.

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Response by:

Jack S Elder, MD, FACS, FAAP Jack S Elder, MD, FACS, FAAP
Clinical Professor of Urology
School of Medicine
Case Western Reserve University