[Upper urinary tract obstruction diagnosis and treatment of congenital hydronephrosis in children]

Twenty nine children under 2 years old with congenital hydronephrosis have been treated in the last 14 years in our department. We report 4 cases which we found difficult to diagnose and treat. The diagnosis and the treatment of congenital hydronephrosis in children are discussed, especially concerning those patients under the age of 2 years. Pyeloplasty has been performed in 28 renal units out of 35 renal units. The results of the procedure were good in 82.1%, fair in 10.7%, no change in 3.6% and a lost case in 3.6%. The Aderson-Hynes dismembered technic was employed except for one renal unit in which the extrarenal pelvis was resected. Hydronephrosis in two renal units and one with nephrostomy for one year and one month improved spontaneously. Endopyelotomy was performed in 2 renal units and will be performed in one renal unit. Nephrectomy was carried out in one renal unit with renal dysplasia. A kidney with dysplasia excreted urine of several ml/day. Post-enhanced-X-ray computed tomography and T1-weighted image of magnetic resonance presented loss of function in the kidney. Degree of stenosis, position of stenosis and function of pelvis and ureter were different in each child. Children are constantly growing up and the condition of stenosis was changed in some cases. In conclusion, we should estimate the stenosis in children using several examinations.