Outcome of congenital hydronephrosis in Qatar

Abstract EN

Three hundred and eleven patients diagnosed to have congenital hydronephrosis proven by postnatal ultrasonography in a ten-year period between 1987 and 1996 were studied retrospectively.

These were classified into mild degree of hydronephrosis in H (64%), moderate in 94 (30 %) and severe in 18 (6 %) patients, according to first post natal sonography and depending on the measurement of the anterio-posterior transverse diameter of the pelvi-calyceal system.

Significant obstructive uropathy was documented in 66 patients by Technetium-Diethylene triamine penta acetic acid renogram (Tc99m DTPA Renogram Vesicoureteric reflux was found in 22 patients by voiding cysto-urethrogram.

On followup the hydronephrosis regressed spontaneously in 99 (31.8%), was stable in 167 (53.6 %) and needed operative intervention in 45 (14.4%) patients.

The types of surgical operations were pyeloplasty in 49 % and ureteric re-implantation in 27%.

Fifteen (83 %) of the children with severe hydronephrosis and 32 (34 %) of the moderate hydronephrosis group were operated o while none of the children with the mild form required operative intervention.

We recommend ultrasound follow-up for mild hydronephrosis and a coordinated approach and work-up for congenital moderate and severe hydronephrosis.

Surgery should only be considered if renal function is affected.