Postnatal management of prenatal hydronephrosis

Neonatal Hydronephrosis is a common abnormality diagnosed antenatally observed in 1% of neonates. Although most cases of prenatal hydronephrosis are due to renal outlet obstruction, vesicoureteral reflux (VUR) is a common cause occurring in 10 to 15 percent of them. Early detection of these abnormalities in neonates and infants is critical due to inducing higher risk of renal damage in very young children. Ultrasonography is the most popular imaging study performed in these neonates. Dynamic renal scan is helpful to determine presence of obstruction and severity of renal function insult. There is a great controversial issue in performing VCUG in neonates with antenatal hydronephrosis. Most authors recommend VCUG for all of them. According to etiologies there are different ways of therapies: surgery for sever degree of obstruction, antibiotic prophylaxis for VUR and observational therapy for others. The most important factors for determining patients’ outcome are severity of renal involvement and correct diagnosis in appropriate time of postnatal life.