Hydronephrosis in Children

Dr. Prathibha Sukumar, Consultant Paediatric Surgeon, SUT Hospital, Pattom

Hydronephrosis is a condition characterized by the swelling of the kidney due to a blockage in the ureter, preventing urine from flowing properly. This condition is commonly seen in infants and can often be detected during an anomaly scan performed after 5 months of pregnancy. In most cases, hydronephrosis resolves naturally after birth, with around 90% of affected infants recovering without intervention. However, for the remaining 10%, regular monitoring through ultrasound scans is essential. Scans are typically scheduled within 3 days of birth, at 1 month, 3 months, and then every 3 months until the baby is 1 year old.

In some cases, hydronephrosis may persist and require surgical intervention, especially when caused by a congenital obstruction in the ureter (Pelviureteric Junction Obstruction – PUJO). Untreated, this blockage can lead to urine stagnation, which affects kidney tissue elasticity and capacity, ultimately causing kidney dysfunction. Early detection and timely treatment are crucial, as advancements in healthcare now allow for the diagnosis of this condition even in unborn babies, preventing complications that were once identified only after significant damage occurred.

When Is Surgery Needed?

Surgery becomes necessary if scans indicate kidney enlargement and urinary obstruction. Pyeloplasty, a surgical procedure to correct the blockage, is performed once all tests confirm the blockage. This can be done via open surgery, laparoscopy (keyhole surgery), or robotic surgery. The narrow area is removed and healthy ureter is rejoined to kidney, and a stent is placed to maintain proper urine flow. The stent is removed about a month later, and follow-up scans are conducted at regular intervals to ensure recovery.

While most children recover fully, some may retain an enlarged kidney size due to prior tissue damage. This is not usually a concern unless further obstruction occurs. Pyeloplasty has a 95% success rate, and repeat surgeries are rare.

Key Takeaways

Early detection through pregnancy scans and timely medical intervention significantly improve outcomes for children with hydronephrosis. Parents should remain vigilant for symptoms such as sudden kidney enlargement or abdominal pain and seek prompt medical attention to ensure the best possible care.

Summary for LinkedIn:Hydronephrosis is a kidney condition caused by ureter blockage, often detected during pregnancy scans. While 90% of cases resolve naturally, others require monitoring or surgery like Pyeloplasty. Early detection ensures better outcomes, preventing complications like kidney dysfunction. Timely scans and follow-ups are vital for effective treatment and recovery.