Postnatal evaluation of intrauterine hydronephrosis due to ureteropelvic junction obstruction

Molina, C.; Facincani, Inalda; Muglia, Valdair Francisco; Araújo, Whemberton Martins de; Cassini, Marcelo Ferreira; Tucci, Sílvio

doi:10.1590/s0102-86502013001300007

Cited by 9 publications

(8 citation statements)

References 28 publications

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“…Nowadays most cases of UPJ obstruction are suspected during pregnancy due to the recent widespread use of ultrasonography in the antenatal period, especially after the 28th week when it is most accurate to study the urogenital tract [1,5]. After labor, in case of suspicion of UPJ obstruction, is highly recommended close surveillance of the newborn by clinical examination, US and renography with MAG3.…”

Section: Discussionmentioning

confidence: 99%

“…After labor, in case of suspicion of UPJ obstruction, is highly recommended close surveillance of the newborn by clinical examination, US and renography with MAG3. Detection of impairment or decrease in split renal function, increase in the antero-posterior diameter, recurrent renal infection and flank pain are the most common indications for surgical treatment [1,5].…”

Section: Discussionmentioning

confidence: 99%

“…With the increasing use of ultrasound in the prenatal evaluation in the mid 80's, nowadays cases of giant hydronephrosis due to UPJ obstruction are uncommonly diagnosed in adults [5].…”

Section: Introductionmentioning

confidence: 99%

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Giant Hydronephrosis - A Late Diagnosis of Ureteropelvic Junction Obstruction

Sepulveda

2013

World J Nephrol Urol

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Ureteropelvic junction obstruction is the most common cause of neonatal hydronephrosis, with an overall incidence of 1:1,500. Since the widespread use of ultrasound in pregnancy, most cases are discovered early in life; however, if the diagnosis isn't suspected in the newborn and the patient remains asymptomatic, the hydronephrosis can progress over time and reach disproportional dimensions. We report a case of giant hydronephrosis in a 27-yearold man presented with severe sepsis secondary to pneumonia and incidental finding of abdominal mass. The current literature is also reviewed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Giant Hydronephrosis - A Late Diagnosis of Ureteropelvic Junction Obstruction

Sepulveda

2013

World J Nephrol Urol

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“…A partir desse momento, diversos estudos mostraram que dilatação ureteropélvica não era necessariamente indicativo de obstrução, registrando que na maioria havia regressão espontânea da hidronefrose e que 40% dos casos de fato apresentavam obstrução de JUP. Hoje com USG no acompanhamento pré-natal é possível diagnóstico a partir da 20ª semana gestacional alguma anormalidade no sistema renal (Molina, 2013;Hachul, 2006). O ultra-som não é um exame que faz o diagnóstico de obstrução, mas permite selecionar crianças em grupos que necessitarão de seguimento mais rigoroso ou de exames complementares, como o de radioisótopos, para oferecer a melhor opção terapêutica (Macedo, 2004).…”

Section: Diagnosticounclassified

Estenose de junção ureteropélvica: Um relato de caso / Ureteropelvic junction stenosis: A case report

Marques¹,

Gomes²,

Oliveira³

et al. 2021

Braz. J. Hea. Rev.

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Objetivo: apresentar um relato de caso de uma criança com estenose de junção ureteropélvica e sua evolução. Descrição do caso: criança, 11 meses de idade, foi detectada dilatação das cavidades pielocalicinais à esquerda no período gestacional, tendo o quadro estabilizado ainda nessa fase. Ao nascimento foi identificado atrofia de rim esquerdo e pequena dilatação ureteropélvica à direita, segue em acompanhamento clínico. Discussão: Apesar da presença de hidronefrose no período antenatal, a criança acompanhada no caso apresentou um quadro de hidronefrose leve em rim direito e atrofia do rim esquerdo, sendo assim, a equipe médica optou por seguir uma conduta conservadora. O protocolo conservador evita exames desnecessários à criança, como se observou neste caso, em que o quadro evoluiu bem sem comprometimento no desenvolvimento da paciente. No prognóstico clínico, espera-se que a dilatação da pelve renal direita regrida até os 2 anos de idade e o desenvolvimento da criança permaneça seu curso normal.

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“…Prenatal hydronephrosis (PNH) is the most common cause of kidney and urinary tract abnormality in perinatal period by a prevalence of 1% to 5% of pregnancies ( 1 - 4 ). Diagnosis of PNH is based on renal ultrasonography (US) before and/or after birth.…”

Section: Introductionmentioning

confidence: 99%

Postnatal Evaluation and Outcome of Prenatal Hydronephrosis

et al. 2016

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Background:Prenatal hydronephrosis (PNH) is dilation in urinary collecting system and is the most frequent neonatal urinary tract abnormality with an incidence of 1% to 5% of all pregnancies. PNH is defined as anteroposterior diameter (APD) of renal pelvis ≥ 4 mm at gestational age (GA) of < 33 weeks and APD ≥ 7 mm at GA of ≥ 33 weeks to 2 months after birth. All patients need to be evaluated after birth by postnatal renal ultrasonography (US). In the vast majority of cases, watchful waiting is the only thing to do; others need medical or surgical therapy.Objectives:There is a direct relationship between APD of renal pelvis and outcome of PNH. Therefore we were to find the best cutoff point APD of renal pelvis which leads to surgical outcome.Patients and Methods:In this retrospective cohort study we followed 200 patients 1 to 60 days old with diagnosis of PNH based on before or after birth ultrasonography; as a prenatal or postnatal detected, respectively. These patients were referred to the nephrology clinic in Zahedan Iran during 2011 to 2013. The first step of investigation was a postnatal renal US, by the same expert radiologist and classifying the patients into 3 groups; normal, mild/moderate and severe. The second step was to perform voiding cystourethrogram (VCUG) for mild/moderate to severe cases at 4 - 6 weeks of life. Tc-diethylene triamine-pentaacetic acid (DTPA) was the last step and for those with normal VCUG who did not show improvement in follow-up examination, US to evaluate obstruction and renal function. Finally all patients with mild/moderate to severe PNH received conservative therapy and surgery was preserved only for progressive cases, obstruction or renal function ≤35%. All patients’ data and radiologic information was recorded in separate data forms, and then analyzed by SPSS (version 22).Results:200 screened PNH patients with male to female ratio 3.5:1 underwent first postnatal control US, of whom 65% had normal, 18% mild/moderate and 17% severe hydronephrosis. 167 patients had VCUG of whom 20.82% with VUR. 112 patients performed DTPA with following results: 50 patients had obstruction and 62 patients showed no obstructive finding. Finally 54% of 200 patients recovered by conservative therapy, 12.5% by surgery and remaining improved without any surgical intervention.Conclusions:The best cutoff point of anteroposterior renal pelvis diameter that led to surgery was 15 mm, with sensitivity 88% and specificity 74%.

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Postnatal evaluation of intrauterine hydronephrosis due to ureteropelvic junction obstruction

Cited by 9 publications

References 28 publications

Giant Hydronephrosis - A Late Diagnosis of Ureteropelvic Junction Obstruction

Giant Hydronephrosis - A Late Diagnosis of Ureteropelvic Junction Obstruction

Estenose de junção ureteropélvica: Um relato de caso / Ureteropelvic junction stenosis: A case report

Postnatal Evaluation and Outcome of Prenatal Hydronephrosis

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