Antenatal Hydronephrosis: A Review of Postnatal Evaluation

Introduction

The advent of fetal sonography has dramatically changed the presentation of the patient with hydronephrosis. Prior to its inception, the detection of urinary anomalies was symptomatic with hematuria, a palpable mass, or a urinary tract infection (UTI) as common presentations for patients with hydronephrosis. With the introduction of fetal sonography in the 1980s, a different population of patients with hydronephrosis was identified asymptomatically with hydronephrosis.

Abstract

The diagnosis, workup, and management of prenatal hydronephrosis has undergone a change from preemptive surgical treatment to a more conservative approach as the natural history of the differential diagnoses becomes more appreciated. A review of the more common differential diagnoses of prenatal hydronephrosis, evaluation, and current treatment options for ureteropelvic junction (UPJ) obstruction, vesicoureteral reflux, ureteroceles, ectopic ureters, megaureters, multicystic dysplastic kidney (MCDK), and posterior urethral valves is undertaken.

Keywords

hydronephrosis, pediatrics, ultrasound