All issues > Volume 49(1); 2006

Original Article

Korean J Pediatr. 2006;49(1):64-70. Published online January 15, 2006.

1 year follow-up results of prenatally diagnosed unilateral hydronephrosis according to renal sonographic findings at 1 month of age

Hoe-Soo HS Yoon¹, Mi Sun MS Yum¹, Joo Hoon JH Lee¹, Young Seo YS Park¹, Kun Seok KS Kim², Chong Hyun CH Yoon³, Dae Hyuk DH Moon³, Hyewon HW 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

Correspondence Young Seo YS Park ,Email: yspark@amc.seoul.co.kr

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.

Keywords :Hydronephrosis , Anterior posterior pelvic diameter(APPD) , Society for fetal urology (SFU) grade , Renal ultrasonography(USG)