Korean J Urol.  2008 Dec;49(12):1125-1130.

Clinical Course of Prenatally-detected Hydronephrosis: Focus on Ureteropelvic Junction Obstruction

• Choi SM
• Jung JH
• Hyun JS
• Chung KH

Abstract

PURPOSE: The diagnosis and treatment of prenatally-diagnosed hydronephrosis remain controversial. We have conducted a retrospective study to examine the clinical characteristics and course of prenatally-diagnosed hydronephrosis, especially when in the presence of ureteropelvic junction obstruction(UPJO).
MATERIALS AND METHODS
Among all pediatric patients diagnosed with hydronephrosis by prenatal ultrasonography between September 2002 and June 2008, the study was performed on 103 patients(126 renal units), and the mean follow-up period was 19.2 months(range, 6-24 months). Ultrasonography was performed 2-3 days after birth, and after 1, 3, 6, and 12 months, and annually thereafter. Hydronephrosis was graded according to the Society for Fetal Urology(SFU) classification guidelines.
RESULTS
On ultrasonography performed 2-3 days after birth hydronephrosis was graded as follows: grade 1, 45(35.7%); grade 2, 49(38.9%); grade 3, 23(18.3%); and grade 4, 9(7.1%) renal units. In cases with UPJO complete improvement of hydronephrosis was detected in 16 renal units(40%); the renal units and rate of complete improvement in grades 1, 2, 3, and 4 were 12(75%), 3(17.6%), 1(16.7%), and 0(0%), respectively. The anticipated times of complete improvement of hydronephrosis in UPJO grades 1, 2, and 3 were 22.0, 31.3, and 50.4 months, respectively.
CONCLUSIONS
In UPJO, the possibility of improvement of hydronephrosis lower than grade 2 was high, and thus follow-up for approximately 30 months may be needed. In patients with hydronephrosis >grade 3, the rate of improvement was low, thus compulsive follow-up is required.

Keyword

Hydronephrosis; Prenatal; Ultrasonography

MeSH Terms

Follow-Up Studies
Humans
Hydronephrosis
Parturition
Retrospective Studies
Ultrasonography, Prenatal

Figure

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  Fig. 1. Clinical course of hydronephrosis in ureteropelvic junction obstruction.

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  Fig. 2. Expected improvement time of hydronephrosis in ureteropelvic junction obstruction. (A) Grade 1 (total 16 renal units) and linear regression trend line. (B) Grade 2 (total 18 renal units) and linear regression trend line. (C) Grade 3 (total 11 renal units) and linear regression trend line. (D) Grade 4 (total 4 renal units) and linear regression trend line.

Reference

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