| 1 year follow-up results of prenatally diagnosed unilateral hydronephrosis according to renal sonographic findings at 1 month of age |
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Hoe-Soo Yoon1, Mi Sun Yum1, Joo Hoon Lee1, Young Seo Park1, Kun Seok Kim2, Chong Hyun Yoon3, Dae Hyuk Moon3, Hyewon Hahn4 |
1Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine
2Department of Urology, Asan Medical Center, University of Ulsan College of Medicine,
3Department of Pediatrics, Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine
4Department of Pediatrics, Eulji University School of Medicine, Seoul, Korea |
| 산전 초음파로 발견된 일측성 수신증의 생후 1개월 때의 초음파 소견에 따른 1년 추적 결과 |
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윤회수1, 염미선1, 이주훈1, 박영서1, 김건석2, 윤종현3, 문대혁3, 한혜원4 |
1울산대학교 의과대학 서울아산병원 소아과
2울산대학교 의과대학 서울아산병원 비뇨기과
3울산대학교 의과대학 서울아산병원 핵의학과
4을지의과대학교 소아과학교실 |
Correspondence:
Young Seo Park, Email: yspark@amc.seoul.co.kr
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| Abstract |
Purpose
: The natural courses of prenatally diagnosed hydronephrosis(HN) are diverse. Our purpose was to determine if the findings of renal ultrasonography(USG) in patients with prenatal HN at 1 month of age can predict the 1 year follow-up results and determine the guideline of follow-up study.
Methods
: Among 462 hydronephrotic patients registered between 1996 and 2004, 153 unilateral hydronephrotic renal units were enrolled in this study, bilateral HN, vesicoureteral reflux and other associated anomaly were excluded. These were classified into four groups respectively, according to anterior posterior pelvic diameter(APPD) or Society for Fetal Urology(SFU) grading by USG findings at 1 month after birth. Renal USG and Tc99m-mercaptoacetyl triglycerine(MAG3) scan were done according to a set protocol.
Results
: Most cases improved or remained stationary. No one underwent an operation SFU grade 1,2 groups and only one case of SFU grade 3 group was operated. Thirty two cases(64 percent) were operated on among the 50 cases of SFU grade 4 group. 0/2(0 percent), 5/11(45.5 percent), 11/ 17(64.7 percent) and 16/20(80 percent) were operated on in each group with APPD <10, 10-19, 20- 29, >30 mm, and the operation risk is higher as the APPD is increased.
Conclusion
: In group with SFU grade below 3 and APPD below 10 mm, we can delay the follow- up study beyond existing set protocol. Operations are recommended immediately if diuretic renogram show the obstructive pattern or decreased renal function in SFU grade 4 group with APPD over 10 mm. |
| Key Words:
Hydronephrosis , Anterior posterior pelvic diameter(APPD) , Society for fetal urology (SFU) grade , Renal ultrasonography(USG) |
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