[Diagnosis and treatment of neonatal hydronephrosis. Influence of prenatal diagnosis]

The objective was to study hydronephrosis, the most common renal malformation during the neonatal period.

We have studied 85 patients (119 renal units) with hydronephrosis. Prenatal and neonatal diagnosis were performed in 83% and 17%, respectively. Diagnosis was made by ultrasound, intravenous urography, voiding cystourethography and diuretic renogram.

The malformations were as follows: Ureteropelvic junction obstruction (UPJ; 40 cases), obstructive megaureter (OM; 16 cases), non-obstructive megaureter (NOM; 9 cases), multicystic kidney (MK; 8 cases), renoureteral duplication (RD; 8 cases) and posterior urethral valves (PUV; 4 cases). Surgical treatment was undergone in 39 cases (14 with UPJ, 10 with OM, 4 with NOM, 4 with MK, 3 with RD and 4 with PUV). Thirty-seven of these cases had prenatal diagnoses.

Conservative therapy was followed in 46 patients (26 with UPJ, 6 with OM, 5 with NOM, 4 with MK and 5 with RD). Thirty of these were prenatally diagnosed. Postnatal mean follow-up was 36 months, using diagnostic methods described previously. Seven cases died (1 from sepsis and 6 others from associated malformations) and 78 patients have good evolution after surgical and conservative treatments.