Management of antenatal hydronephrosis

AbstractAntenatal hydronephrosis (AHN) is the most frequently detected abnormality by prenatal ultrasonography. Differential diagnosis of AHN includes a wide variety of congenital abnormalities of the kidney and urinary tract ranging from mild abnormalities such as transient or isolated AHN to more important ones as high-grade congenital vesicoureteral reflux or ureteropelvic junction obstruction. It is well known that the outcome depends on the underlying etiology. Various grading systems have been proposed for the classification of AHN on prenatal and postnatal ultrasonography. Mild isolated AHN represents up to 80% of cases, is considered to be benign, and majority of them resolve, stabilize, or improve during follow-up. Controversies exist regarding the diagnosis and management of some important and severe causes of AHN such as high-grade vesicoureteral reflux and ureteropelvic junction obstruction. Current approach is becoming increasingly conservative during diagnosis and follow-up of these patients with less imaging and close follow-up. However, there is still no consensus regarding the clinical significance, postnatal evaluation, and management of infants with AHN. The aim of this review is to discuss the controversies and provide an overview on the management of AHN.
Source: Pediatric Nephrology - Category: Urology & Nephrology Source Type: research

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Publication date: Available online 13 January 2020Source: Urology Case ReportsAuthor(s): Meng-Tian Liang, Chao Wang, Fa Zhang, Feng-Hai ZhouAbstractA 48-year-old man was presented in the local hospitalized where he lived because of lower back pain one month ago. Then he came to our hospital for kidney stones on the right side within horseshoe kidneys and hydronephrosis diagnosed by imaging and abdominal ultrasound. After we proceeded single standard percutaneous nephrolithotomy with holmium laser combined EMS, his stones were totally removed with little intraoperative bleeding. No eventful post-operative complications occu...
Source: Urology Case Reports - Category: Urology & Nephrology Source Type: research
Shailesh Chandra Sahay, Dilip Bhalla, Pawan Kesarwani, Madan SethiUrology Annals 2020 12(1):90-91 Herniation of the urinary bladder is observed in around 1%–4% of cases. Bladder herniation rarely presents with obstructive uropathy; however, bladder herniation carrying ureteroneocystostomy and leading to obstructive uropathy of the graft is even rare. Here, we present a case of a 36-year-old male with deranged renal function test who had undergone renal transplant 10 years back. Computed tomography scan revealed bladder herniation with ureteroneocystostomy and hydronephrosis. He was surgically explored by Gib...
Source: Urology Annals - Category: Urology & Nephrology Authors: Source Type: research
AbstractPurposeTo share experience in managing ureteral strictures following ureteroscopic lithotripsy.MethodsNinety five patients diagnosed as ureteral strictures after ureteroscopic lithotripsy between January 2013 and January 2018 were included. 53 received endourological treatment, 34 underwent reconstruction, 6 underwent nephrectomy for severe renal impairment, and 2 chose routine ureteral stent replacement. Therapeutic success was defined as absence of clinical symptoms and radiologic relief of obstruction.ResultsThe follow-up time ranged from 13 to 57  months, with a median time of 24. It lasted more than 13&nb...
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research
AbstractPurposeTo evaluate predictive factors affecting the stone-free rates (SFR) and complications of minimally invasive percutaneous nephrolithotomy (MPCNL) under local infiltration anesthesia (LIA)MethodsA retrospective analysis was conducted on 976 consecutive patients who underwent MPCNL under LIA from January 2015 to June 2018. Postoperative complications were classified according to modified Clavien classification system. Univariate and multivariate logistic regression analyses were used to determine factors affecting SFR and complications.ResultsThe pain was acceptable with postoperative visual analog scale (VAS) ...
Source: World Journal of Urology - Category: Urology & Nephrology Source Type: research
Neurogenic bladder (NGB) patients require periodic urodynamics (UDS) to evaluate bladder function which, in turn, helps guide management. At times, bladder decompensation or hydronephrosis may develop in patients between UDS testing intervals. Increased surveillance has improved outcomes in other chronic conditions (e.g. diabetes). Two novel devices, the cystomanometer (CM) and cystoelastometer (CEM) have been developed at our institution to allow for home bladder pressure monitoring. The hand-held CM attaches to the end of any catheter and records the opening bladder pressure along with a timestamp.
Source: Journal of Pediatric Urology - Category: Urology & Nephrology Authors: Source Type: research
CONCLUSION: CMSPI is feasible for bridging long ureteral defects and has shown good efficacy in this preliminary study. PMID: 31912471 [PubMed - as supplied by publisher]
Source: Urology Journal - Category: Urology & Nephrology Authors: Tags: Urol J Source Type: research
Aim to illuminate the correlation between fetal hydronephrosis and postnatal urological abnormalities by a new classification system—“urinary tract dilation (UTD)” grade. Of 659 pregnancies screened by ultrasound, 34 cases were found with isolated fetal hydronephrosis, and enrolled in our study from 2017 to 2019. These 34 infants had been prospectively followed up to 6 months after birth by 3 times of urinary tract ultrasound. Hydronephrosis was graded in accordance with the UTD classification system. Among 34 infants with isolated fetal hydronephrosis. Twenty-four (70.6%) were classified as UTD A1 grad...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
ConclusionEarly diagnostic imaging with CT while a patient is symptomatic can aid in making an accurate diagnosis. Laparoscopic repair can be safely used with good outcome in the context of an incarcerated obturator hernia.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
Conclusions. TE together with additional signs of ATI indicates occult UOC. This histological phenotype should trigger more detailed evaluation for UOC when there is no evidence of relevant hydronephrosis in the ultrasonography.
Source: Transplantation - Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research
A six-month-old child was admitted into our center with complaint of hydronephrosis in June 2018. He was diagnosed as embryoid rhabdomyosarcoma after cystoscopy with biopsy. After 22Gy radiotherapy and 4 cycles chemotherapy(VAC), robot-assisted radical cystectomy was performed. The orthotopic neobladder was reconstructed with sigmoid colon and bilateral ureter were reimplanted in Politano-Leadbetter technique. The patient was discharged after 14 days and chemotherapy was continued. Recent ultrasound examination showed that his maximal bladder capacity had increased to 120 ml, and intravenous urography revealed no urine leakage.
Source: Urology - Category: Urology & Nephrology Authors: Source Type: research
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