[Hydronephrosis: comparison of conservative and surgical treatment]
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Published on: July 8, 2025
E Cemerlic-Zecevic1, D Milicic-Pokrajac
1Pedijatrijska klinika, Klinicki centar Univerziteta u Sarajevu.
Insights
Ultrasound effectively diagnoses pediatric hydronephrosis, identifying causes like vesicoureteral reflux and obstructive conditions. Early detection via ultrasound improves management of urinary tract anomalies in children.
Area of Science:
- Pediatric Urology
- Diagnostic Imaging
- Medical Diagnostics
Background:
- Hydronephrosis in children requires timely diagnosis for effective treatment.
- Congenital urinary tract anomalies are a common cause of pediatric hydronephrosis.
Purpose of the Study:
- To evaluate the role of ultrasound in the early diagnosis of hydronephrosis in children.
- To identify the causes and types of hydronephrosis in the pediatric population.
Main Methods:
- Routine ultrasound screening for hydronephrosis detection.
- Standard urography and micturition cystourethrography for further evaluation.
- Analysis of 48 pediatric cases diagnosed with hydronephrosis.
Main Results:
- Ultrasound identified hydronephrosis in 48 children, categorized into non-obstructive (37.5%) and obstructive (62.5%) types.
- Vesicoureteral reflux was the primary cause of non-obstructive hydronephrosis, predominantly in girls aged 1-5.
- Obstructive hydronephrosis, mainly seen in neonatal boys, was often linked to ureterovesical junction obstruction; 50% of all patients underwent surgery.
Conclusions:
- Widespread adoption of ultrasound significantly enhances the diagnostic accuracy of urinary tract anomalies in children.
- Ultrasound is a crucial tool for early detection and improved management of pediatric hydronephrosis.
Objectives:
Early diagnosis and identification of adequate treatment of children with hydronephrosis.
Methods:
Routine ultrasound testing was followed by standard urography and micturacion cystouretrogam among those identified with hydronephrosis.
Results:
We showed 48 children among whom the ultrasound detected hydronephrosis of various degrees. First group consists of patients with non-obstructive hydronephrosis 18 patients (37.5%); the highest percentage among girls (88.3%), ages 1-5. The cause of hydronephrosis is the vesicoureteral reflux. The second group with obstructive hydronephrosis consists of 30 patients (62.5%), only one of them had obstruction ureterovesical junction. Neonatal boys dominate in this group. 50% of patients from both groups were surgically treated.
Conclusion:
Wide use of ultrasound provided for a significant improvement in diagnosis of urinary-tract anomalies.
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