How is bilateral antenatal hydronephrosis treated?

Updated: Dec 16, 2020
  • Author: Dennis G Lusaya, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

Infants with severe bilateral antenatal hydronephrosis and/or bladder distension are at increased likelihood of having significant disease. These infants and those with a severe hydronephrotic solitary kidney should be evaluated initially by ultrasonography on the first postnatal day. Bilateral hydronephrosis suggests an obstructive process at the level of or distal to the bladder, such as ureterocele or posterior urethral valves (PUV) in a male infant, which can be associated with impaired renal function and ongoing renal injury.

If postnatal ultrasonography demonstrates persistent hydronephrosis, voiding cystourethrography (VCUG) should be performed. In male infants, the posterior urethra should be fully evaluated to detect possible PUVs.

Infants with mild or moderate hydronephrosis can be evaluated after 7 days of life.


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