Natural History of Unilateral Ureteropelvic Junction Obstruction : Five Cases of High Grade Hydronephrosis

Chung, Ky Hyun; Hwa, Jeong Seok; Paik, Sang Hoon; Pak, Jin Soo; Lim, Jin Kyu; Choi, Jae Hoon

J Korean Soc Pediatr Nephrol > Volume 4(1); 2000 > Article

J Korean Soc Pediatr Nephrol 2000;4(1): 57-62.

신생아 편측 신우요관이행부 폐색의 자연경과 : 중증 수신증 5례

정기현, 화정석, 백상훈, 박진수, 임진규, 최재훈

¹경상대학교 의과대학 비뇨기과학교실
²경상대학교 의과대학 비뇨기과학교실
³경상대학교 의과대학 비뇨기과학교실
⁴경상대학교 의과대학 비뇨기과학교실
⁵경상대학교 의과대학 비뇨기과학교실
⁶경상대학교 의과대학 비뇨기과학교실

Natural History of Unilateral Ureteropelvic Junction Obstruction : Five Cases of High Grade Hydronephrosis

Ky Hyun Chung, Jeong Seok Hwa, Sang Hoon Paik, Jin Soo Pak, Jin Kyu Lim, Jae Hoon Choi

¹Department of Urology, College of Medicine, Gyeongsang University
²Department of Urology, College of Medicine, Gyeongsang University
³Department of Urology, College of Medicine, Gyeongsang University
⁴Department of Urology, College of Medicine, Gyeongsang University
⁵Department of Urology, College of Medicine, Gyeongsang University
⁶Department of Urology, College of Medicine, Gyeongsang University

ABSTRACT

Purpose: Unilateral ureteropelvic junction obstruction with high grade of hydronephrosis an obstructed diuretic renogram but good differential renal function were studied to evaluate the natural history of untreated obstruction. Materials and
Methods: During the last three years, we encountered 18 kidneys with hydronephrosis detected on prenatal ultrasound. In all these patients other urologic abnormalities were excluded by voiding cystourethrography and other radiological studies. Diuretic renography was initially performed at an age ranging from 2 weeks to 4 weeks. Five had high degree of hydronephrosis and obstructed diuretic renogram despite good relative renal function. Periodic urine examination, ultrasonography and diuretic renogram were done at regular intervals.
Results : We have followed 5 neonates with unilateral hydronephrosis and suspected ureteropelvic junction obstruction with noroperative treatment for 15 months. During followup, percentage and relative renal function were maintained in all patients and hydronephrosis improved. Obstructive patterns on diuretic renogram were variable.
Conclusions : These findings help to define the natural history of untreated good functioning hydronephrotic kidneys. Many newborn kidneys with severe hydronephrosis are not obstructed despite even high grade of hydronephrosis and obstructed diuretic renogram.

Key words: Ureteropelvic junction obstruction | Natural history