Congenital hydronephrosis

1. Congenital hydronephrosis
NAME: IBRAHIM KEWAN
GROUP: M1751

2. Congenital hydronephrosis
Congenital hydronephrosis is a medical term to
describe children who were born with a build-up
of urine in their kidneys.

3. Causes
Hydronephrosis can be caused by blockage at some part of the urinary tract or by reflux of urine
(abnormal backflow of urine from the bladder). It can also be due to the abnormal development
or formation of the kidney in the absence of obstruction or reflux. There are few genetic causes
of hydronephrosis and it can occur with other conditions in the baby.

4. Categories of hydronephrosis:
There are three major categories of hydronephrosis:
• Vesicoureteral reflux: is when urine does not properly flow from the kidneys to the bladder, but
instead abnormally backs up in the ureter.
• Blockage/obstruction: occurring in four possible places:
- Where the kidney meets the ureter (ureteropelvic junction – UPJ)
- Where the ureter meets the bladder (ureterovesical junction – UVJ)
- Within the urethra (the tube that carries urine from the bladder out of the body, occurring only in males) (posterior
urethral valves – PUV)
- Incorrect attachment of the ureter to the bladder (ectopic ureter or ureterocele)
• Idiopathic hydronephrosis that has no obvious cause and usually resolves on its own before or
after birth

5. Symptoms
• Pain in the side or abdomen
• Blood in the urine
• Persistent feeling of needing to urinate
• Pain in the lower abdomen during urination
• Cloudy or bloody urine
• Back or side pain
• Fever
• Vomiting

6. Treatment
There are four main options for treatment, depending on the severity of hydronephrosis in the
baby:
• Close observation: for mild or moderate cases, including ultrasounds before and after birth
• Antibiotics: after baby is born to prevent infection, in select cases where infection may be more
likely to occur
• Surgery: to repair any urinary tract blockage, in more severe cases
• Prenatal surgery: to place a drainage tube in the baby’s bladder, in the most severe cases