The role of ultrasonography in the assessment of congenital hydronephrosis

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The role of ultrasonography in the assessment of congenital hydronephrosis

Otilia Fufezan, Simona Tatar, Gheorghe Cobzac, Mirela Chereches

Abstract

Abstract

Anomalies of the reno-urinary tract are very frequent in pediatrics. The pelviureteric junction obstruction is the most frequent of the obstructive anomalies of the urinary tract. The aim of this study was to determine the ultrasonographic evolution of the pelvic dilatations and of the renal parenchyma thickness in patients with congenital hydronephrosis who underwent either surgery or conservative treatment. Methodology. The study group consisted of 36 patients with hydronephrosis. The including criteria was the presence of IInd-IVth degree unilateral congenital hydronephrosis. Excluding criteria were represented by bilateral severe hydronephrosis, unique kidney, vesico-ureteric refl ux and other associated ureteral anomalies. All patients were examined through reno-urinary ultrasonography, voiding urethrocystography and diuretic renal scintigraphy. Reno-urinary ultrasonography determined the following parameters: the anterior-posterior diameter of the renal pelvis and the thickness of the renal parenchyma. Results. In 13 patients a conservative approach was adopted and the other 23 patients underwent pyeloplasty. Pyeloplasty was performed during infancy in 6 patients, between the ages of 2 and 3 in another 6 patients and in 11 patients after the age of 3. 11 out 13 of the patients who were treated conservatively had a favorable evolution. Pyeloplasty before the age of 3 also had a favorable outcome, but no signifi cant improvement of the renal parenchyma thickness was seen in patients who underwent surgery after the age of 3 (p=0,40). As a complication we mention one of the 23 pyeloplsties that were unsuccessful. In conclusion, the authors show a decrease of the pelvic dilatation after pyeloplasty in all age groups. An improvement of renal parenchyma thickness was observed in patients who underwent surgery before the age of three.

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