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

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

PATIENTS AND METHODS: 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.

RESULTS: 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.

CONCLUSIONS: 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.