An alternative grading system to refine the criteria for severity of hydronephrosis and optimal treatment guidelines in neonates with primary UPJ-type hydronephrosis

Long-term follow-up and management of prenatally detected, isolated hydronephrosis

“…In recent years, the evaluation and management of asymptomatic hydronephrosis has evolved rapidly (including early surgery or close observation until deterioration of renal function or progression of hydronephrosis), generating enormous controversy [5][6][7]. Most cases of antenatally diagnosed hydronephrosis have been shown to be benign and with spontaneous resolution [2,[8][9][10][11][12][13][14][15]. In contrast, Chertin et al [7] reported that more than 50% of patients with hydronephrosis underwent pyeloplasty because of a deterioration in renal function.…”

“…Significant obstruction remained untreated for longer periods but unfortunately produced permanent loss of renal function that in many cases was not reversible despite successful pyeloplasty [2,7,12,[17][18][19][20][21]. If significant progression of hydronephrosis is not treated surgically, most children will lose renal function at some stage [14]. Therefore, we suggested that earlier surgical intervention after a short period of strict clinical surveillance might be safer than long, unnecessarily invasive and costly follow-up in patients with persistent grade 3/4 hydronephrosis.…”

Pelvis/cortex ratio: An early marker of success following pyeloplasty in children

“…Kis et al [7] showed that resolution in hydronephrosis is slow but parenchymal growth is rapid following surgery. Onen [9] showed that neither the Society of Fetal Urology system nor APPD could act as the gold standard in determining the severity of hydronephrosis.…”

Opinions of the Pediatric Surgery Specialists in Turkey on Ultrasonography (USG) Training

“…Rutin uygulamalarda birçok çocuk cerrahisi kliniğinde üriner sistem tanı ve tedavisinde (nefrostomi kateteri takılması, sistofiks kateteri takılması gibi), santral kateter takılması (port kateteri) sırasında USG kullanılmaktadır (7) . Çocuk cerrahisi uzmanı tarafından USG ile ortaya konulmuş ve kabul görmüş hidronefroz sınıflandırması dahi mevcuttur (8) . Çocuk cerrahisi eğitiminde USG'nin olmamasına rağmen, bazı çocuk cerrahlarının kendi olanaklarıyla USG öğ-renmeye çalışması ve kendi kliniklerinde kullanmaya çalışması bu gereksinimin sonucu olarak düşünüle-bilir.…”