Hydronephrosis
Hydronephrosis
Antenatal diagnosis (also called Prenatal Diagnosis) refers to diagnosis of congenital disorders while the baby is still in mother’s womb. This is the cutting edge of medical science. The once opaque womb has become accessible and transparent due to advent of high resolution ultrasound. Till some years back, pediatricians and pediatric surgeons used to feel helpless when they used to see a newborn with a severe congenital defect. In the present era, a large number of these anomalies are diagnosed even before the birth of the baby.
Ultrasound can diagnose structural abnormalities in the fetus after 16 weeks once the miniature organs are in place. As expected the specificity increases as the baby grows bigger. This is a whole new group of diseases – “Antenatally diagnosed disorders” or we call them “Unborn Patients”
The major types of defects seen in unborn babies are kidney abnormalities (swelling, absent kidney), hydrocephalus (excessive brain fluid leading to pressure damage on brain), cardiac anomalies, neural tube defects, certain chromosomal disorders, lung anomalies, tumors and cysts in belly.
Kidney abnormalities are one of the most common antenatally diagnosed disorders, found in approximately 1% of all fetuses but the good part is that in up to 80% of them it may be a very mild transient swelling which resolves either before or after birth.
Definition of Antenatal Hydronephrosis
Antenatal hydronephrosis refers to fluid-filled swelling of the kidney detected before birth in the fetus by ultrasound studies. Hydronephrosis can be diagnosed as early as the 15 weeks of pregnancy. In most instances this diagnosis does not change obstetric care, but will require careful follow-up and possible evaluation & surgery after birth during infancy and childhood.
Possible causes of antenatal hydronephrosis include:
Blockage:This may occur at the junction of the kidney and the drainage pipe (ureter) a junction called Ureteropelvic junction (UPJ/ PUJ), or at the bladder and the ureter (ureterovesical junction), or in the urethra (posterior urethral valves).
Reflux:Vesicoureteral reflux (VUR) refers to reverse flow of urine from bladder to the kidney. This occurs when the valve between the bladder and the ureter does not function properly, permitting urine flow back up to the kidney when the bladder is full or the child is passing urine. Most children with VUR (75%) will outgrow reflux and stop refluxing during childhood but urinary infections need to be diagnosed and treated early to prevent kidney damage. A low dose daily antibiotic prophylaxis also helps in these children.
Duplications:Presence of double ureters is a common condition and occurs in 1% of all humans. These may show up on fetal ultrasound if any of the tube is swollen. Occasionally patients with duplication have a Ureterocele (balloon-like obstruction at the end of one of the duplex tubes) leading to obstruction to urine flow and a swelling of the kidney.
Multicystic kidney:A nonfunctional kidney looks like a bunch of grapes.
No significant Abnormality:Many of these kidneys with swelling prove to be normal after delivery.
UPJ obstruction: block at the left ureteropelvic junction or UPJ or PUJ (where ureter joins to the kidney)
Posterior urethral valves: block at the outlet of the bladder
Vesicoureteral reflux on the left: flow of urine back up ureter causing dilated ureter and kidney
Multicystic kidney on the left: kidney may be large due to multiple cysts, leading to detection on ultrasound
Duplication of ureters on both sides with ureterocele (seen where ureter joins bladder) on left causing blockage
Management of Antenatal Hydronephrosis
Most cases of antenatal hydronephrosis diagnosed during pregnancy are just followed monthly with ultrasound, monitoring the growth of the fetus and the swelling of the kidneys. In these cases, a normal delivery can be performed. Rarely, in a fetus with severe obstruction involving both the kidneys and insufficient amniotic fluid, drainage of the kidneys or bladder by a catheter tube or operation may need to be done. In these babies, however, the kidneys are often very abnormal and do not function properly in upto 50% regardless of treatment.
Post birth Evaluation
Several studies may need to be performed to evaluate the kidneys:
➾ Ultrasound (done during the newborn period) – for one sided swelling after one week and earlier if both the kidneys are swollen
➾ Voiding or micturating cystourethrogram (VCUG/MCU) is done in selected cases to exclude vesicoureteral reflux and urethral blocks like PUV
➾ Diuretic renal scan may be done to evaluate drainage and kidney function
➾ Blood tests like serum creatinine to evaluate kidney function.
Treatment
➾ The treatment of antenatal hydronephrosis depends on the underlying cause.Vesicoureteral reflux (VUR): Infants and children with who have vesicoureteral reflux are managed with antibiotics and surveillance with periodic ultrasounds and voiding cystograms.
➾ Obstruction: Infants and children with an obstruction or blockage of the urinary tract may require surgical correction.
➾ Babies with hydronephrosis without reflux or obstruction are followed with periodic ultrasounds to monitor the hydronephrosis and the growth of the kidneys.
➾ The management of multicystic dysplastic kidneys is observation as the opposite kidney is usually normal. Non-functioning multicystic kidney is removed only if its large size causes problems or there is a doubt of tumor or blockage.
Testimonials
Real reviews from our patients on Google
Kranti Tandel
2 months ago
From the moment I walked into the hospital until the day I was discharged, I felt genuinely cared for.
A heartfelt thank you to Dr. Manish Dubey for making such a stressful time feel so much easier. His calm nature, patience, and the way he explains everything instantly put me at ease. They say half the healing begins when you trust your doctor, and that’s exactly how I felt with him. The procedure was far less painful than I had imagined, and I truly believe that’s because of his skill and the confidence he gives his patients.
The nursing staff was absolutely wonderful
kind, compassionate, attentive, and always there whenever I needed help. Every member of the hospital and hospitality staff treated me with warmth, respect, and genuine care, which made all the difference during my recovery.
It’s rare to find a team that is not only excellent at what they do but also so humane and compassionate. Thank you to Dr. Manish Dubey and the entire team for making my journey so comfortable. I will always be grateful and would wholeheartedly recommend this hospital to anyone looking for exceptional medical care.
Read moreA heartfelt thank you to Dr. Manish Dubey for making such a stressful time feel so much easier. His calm nature, patience, and the way he explains everything instantly put me at ease. They say half the healing begins when you trust your doctor, and that’s exactly how I felt with him. The procedure was far less painful than I had imagined, and I truly believe that’s because of his skill and the confidence he gives his patients.
The nursing staff was absolutely wonderful
kind, compassionate, attentive, and always there whenever I needed help. Every member of the hospital and hospitality staff treated me with warmth, respect, and genuine care, which made all the difference during my recovery.
It’s rare to find a team that is not only excellent at what they do but also so humane and compassionate. Thank you to Dr. Manish Dubey and the entire team for making my journey so comfortable. I will always be grateful and would wholeheartedly recommend this hospital to anyone looking for exceptional medical care.
Shilpa Nair
4 months ago
I had an excellent experience and am very grateful for the care and support I received. The entire staff was professional, friendly, and attentive, making me feel comfortable throughout the process.
A special thank you to Dr. Vijaykumar Yadav for his expertise, patience, and compassionate approach. He took the time to explain everything clearly and ensured that all my concerns were addressed. His dedication to patient care is truly commendable.
I highly recommend this place to anyone seeking quality treatment and outstanding service. Thank you once again, Dr. Vijaykumar Yadav, for your exceptional care!
Read moreA special thank you to Dr. Vijaykumar Yadav for his expertise, patience, and compassionate approach. He took the time to explain everything clearly and ensured that all my concerns were addressed. His dedication to patient care is truly commendable.
I highly recommend this place to anyone seeking quality treatment and outstanding service. Thank you once again, Dr. Vijaykumar Yadav, for your exceptional care!
Mahendra Patil
4 months ago
My 3 years 11 month year old daughter was diagnosed with 10 mm kidney stone Dr.A.k.Singhal,Dr.Manish Dubey,and Dr.Ashwita Shenoy performed the surgery to remove the stone on May 30th with immense success. I am deeply grateful for the exceptional care and professionalism demonstrated by this entire team.
From the very beginning,the doctors explained every detail of the treatment process with great patience and clarity, this provided us as parents with immense relief and put our minds completely at ease. The surgery proceeded very smoothly and thanks to the doctors expertise and dedication my daughter is now completely healthy and in excellent health
I would also like to extend my special thanks Dr.A.k. Singhal , Dr. Ashwita Shenoy for providing us with constant support and guidance throughout this entire process.they were always available to answer our questions and ensured that our daughter received the very best treatment . Thank you mitra hospital. Thank you so very much for taking such excellent care of my daughter and for making this difficult time for our family SO much more bearable.
और
मेरी बेटी को left inguinal harniya भी hua था उसकी भी सर्जरी करणी जरुरी थी और DJ स्टेट removal भी करना था june 20 th को मेरे बेटी का Dr. Ashwita Shenoy मॅडम ने left inguinal harniya की surgery बहुत आछी तरह की और DJ स्टेट भी निकाली मेरे बेटी का सब अच्छा हुवा thank you mitr hospital All team thanks Dr. Ashwita Shenoy मॅडम मेरे परिवार के तरफ से आपको और आपके पुरे टीम को धन्यवाद.
excellent treatment my daughter
Thank you mitr hospital
Read moreFrom the very beginning,the doctors explained every detail of the treatment process with great patience and clarity, this provided us as parents with immense relief and put our minds completely at ease. The surgery proceeded very smoothly and thanks to the doctors expertise and dedication my daughter is now completely healthy and in excellent health
I would also like to extend my special thanks Dr.A.k. Singhal , Dr. Ashwita Shenoy for providing us with constant support and guidance throughout this entire process.they were always available to answer our questions and ensured that our daughter received the very best treatment . Thank you mitra hospital. Thank you so very much for taking such excellent care of my daughter and for making this difficult time for our family SO much more bearable.
और
मेरी बेटी को left inguinal harniya भी hua था उसकी भी सर्जरी करणी जरुरी थी और DJ स्टेट removal भी करना था june 20 th को मेरे बेटी का Dr. Ashwita Shenoy मॅडम ने left inguinal harniya की surgery बहुत आछी तरह की और DJ स्टेट भी निकाली मेरे बेटी का सब अच्छा हुवा thank you mitr hospital All team thanks Dr. Ashwita Shenoy मॅडम मेरे परिवार के तरफ से आपको और आपके पुरे टीम को धन्यवाद.
excellent treatment my daughter
Thank you mitr hospital
Purva Shingare
4 months ago
Had kidney stone surgery done by Dr Manish Dubey. All staff was cooperative. Doctor Dubey made me so much relaxed that I was not at all worried about the procedure. Other doctors in the OT were also very sweet. The staff is very nice, hospital is clean ,no smell of medicines, housekeeping services are very good. Hospital food is also very nice,tasty and healthy. Insurance procedure is also very easy. The surgery procedure went so smoothly. I would surely recommend Mitr Hospital and special thanks to Dr Dubey.
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Nikita Ghodke
6 months ago
I had an amazing experience at the hospital, which offers excellent facilities and truly stands out in terms of care and support. I was under the treatment of Dr. Vijaykumar Yadav, who is exceptional in his field. His kindness, compassion, and dedication to his work made a significant difference throughout my journey.
He is highly detail-oriented and experienced, ensuring I felt confident and well-informed at every step. I underwent two surgeries, and he consistently reassured me and focused on my recovery and well-being. What truly sets him apart is his availability, he was always there whenever needed, even late at night.
Overall, the hospital is outstanding and undoubtedly one of the best in Navi Mumbai. I’m truly grateful for the care I received.
Read moreHe is highly detail-oriented and experienced, ensuring I felt confident and well-informed at every step. I underwent two surgeries, and he consistently reassured me and focused on my recovery and well-being. What truly sets him apart is his availability, he was always there whenever needed, even late at night.
Overall, the hospital is outstanding and undoubtedly one of the best in Navi Mumbai. I’m truly grateful for the care I received.
Dimple Choudhary
1 year ago
Very polite staff N great service ☺️
Ketan Bhagat
1 year ago
Excellent,
We had a nice experience with Mitr hospital. Dr.A.K.Singal is such a talented Child urologist and nice person. Staff are good. Thank you so much Dr.A.K.Singal sir and Dr.Ashvitha Mam for treating our daughter so well and saving her life.. We w'l be gratful to you throughout our life..
Read moreWe had a nice experience with Mitr hospital. Dr.A.K.Singal is such a talented Child urologist and nice person. Staff are good. Thank you so much Dr.A.K.Singal sir and Dr.Ashvitha Mam for treating our daughter so well and saving her life.. We w'l be gratful to you throughout our life..
Pankaj Choudhary
1 year ago
Very experienced Doctor and cooperative staff. They give full time to patients for there Query and problems.
Blood test Camp organised for Woman's day was support and very helpful
Read moreBlood test Camp organised for Woman's day was support and very helpful
Sneha Omale
1 year ago
डॉ. अमित घरत इंडॉस्कॉपी खूप छान पध्दती ने केली . धन्यवाद डॉक्टर आणि त्यांची टीम . वेळोवेळी मदत केली बद्दल.
prathamesh palkar
1 year ago
“I am extremely grateful for the excellent service provided by Mr.Aditya Sir from the hospital TPA insurance team. He was incredibly professional, patient, and thorough in explaining my insurance coverage and guiding me through the entire process. His prompt assistance and dedication made everything smooth and hassle-free. I truly appreciate his kindness and efficiency in handling my queries. Thank you, Aditya Sir, for your outstanding support!”
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