[Hydronephrosis in childhood. Long and mid-term morphologic and functional results]

Hydronephrosis in infancy and childhood is a frequent urinary malformation and is almost always congenital. In over 80% of the cases it is due to ureteropelvic junction obstruction; in about 17%, anomalous renal vessels at the ureteropelvic junction are present. The authors analyze their experience in the surgical treatment of hydronephrosis. 360 hydronephrosis out of 335 patients were operated on from November 1971 to November 1988. 108 patients were less than 1 year old (32.2%). Primary nephrectomy was carried out only in 11 of the 360 hydronephrosis operated on (about 3%). An anterior approach and a simple dismembering pyeloplasty were performed in the majority of the cases. From the radiological point of view there was an impressive amelioration or normalization in about 92% of the cases operated on. From the functional point of view the radionuclide scan showed a normal or slightly reduced renal function in almost 90% of the cases operated on. The preoperative and postoperative radionuclide study showed a moderate increase of the renal function in the majority of the cases controlled. The authors stress the importance of prenatal ultrasound diagnosis to improve long term results of an early surgical treatment.