ESPN 50th Annual Meeting

ESPN 2017


 
FOLLOW-UP OF PATIENTS WITH HYDRONEPRHOSIS; WHEN TO WORRY?
UMUT SELDA BAYRAKCI 1 BUSRA FILIZ 2 EMEL Ä°SIYEL 2 ASLI KANTAR OZSAHIN 2 SEMSA CAYCI 2 TUGRUL TIRYAKI 2

1- ANKARA YILDIRIM BEYAZIT UNIVERSITY DEPARTMENT OF PEDIATRIC NEPHROLOGY
2- ANKARA CHILD HEALTH HEMATOLOGY ONCOLOGY RESEARCH AND TRAINING HOSPITAL
 
Introduction:

 Hydronephrosis is the most common genitourinary system anomaly detected by ultrasound (US) during antenatal period. However, there is no consensus about evaluation and follow-up of these patients in postnatal period.

Material and methods:

 The data of 203 patients followed with hydronephrosis since 2010 were evaluated retrospectively and the role of postnatal ultrasonography (US) in predicting the final diagnosis and need of surgery was investigated. Patient’s the first postnatal, second and the last US, voiding cystourethrography (VCUG) and diuretic renograms (MAG3) were recorded. US findings of different etiologies, anteroposterior diameters (APD) of operated/nonoperated groups are compared.

Results:

 Regarding the renal pelvic APD in the first postnatal US; mild, moderate and severe HN was detected in 23.1%, 34.4%, 42.4% of them respectively. It was determined that according to the first USG, patients with low grade of hydronephrosis had higher recovery rate and first USG findings gave reliable information about prognosis. The risk of obstruction and surgical intervention increased significantly with the increase in the degree of hydronephrosis in the first USG. Renal pelvic APD of ≤ 11 mm was found to be an important predictor of complete recovery (p<0.001; AUC: 0.714). 

Conclusions:

The first USG findings give reliable information about prognosis of patients and guide us to select the appropriate imaging studies and to determine the need for antibiotic prophylaxis at the same time. The risk of obstruction and surgical interventions increased significantly with the higher degrees of hydronephrosis in the first USG of patient.