• Clinical and Experimental Pediatrics
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• v.49 no.8
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• pp.870-874
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• 2006

Purpose : Popular use of fetal ultrasonography has increased to detect congenital hydronephrosis(CH) which is the most common anomaly prenatally detected. We'd like to determine the frequency and clinical characteristics of prenatally diagnosed CH and outcome of ureteropelvic junction stenosis(UPJS). Methods : The records of births between January 1994 and June 2003 in Chonnam National University Hospital(CNUH), and the records of children who were diagnosed with CH in the Department of Pediatrics of CNUH during the above period, were retrospectively analyzed. In the patients with UPJS, the initial anterior posterior diameters of renal pelvis(APD) were compared between the spontaneous regression (SR) and operation group(OP). In the SR group, sequential regression rates of APD were estimated. Results : Among a total 9,076 births, 231(2.54 percent) patients with 293 renal units were diagnosed as CH and 19(6.78 percent) renal units spontaneously regressed 3 days after birth. In 228 children(56 bilateral; 172 unilateral; total 284 renal units) diagnosed with CH in the department of pediatrics of CNUH, male(71.9 percent) and left kidney(69.2 percent) predilection were found and 78.1 percent of CH were caused by UPJS. The initial APD of the SR group(121 units) in UPJS was $7.8{\pm}6.28mm$, which was significantly smaller than the APD($26.8{\pm}12.14mm$) of the OP group(25 unit)(P<0.05). In the SR group, 81 percent spontaneously regressed within one year. Conclusions : In CH, male and left kidney predilection were found. UPJS was the most common cause of CH and initial APD in UPJS at 3 days of age was a good prognostic indicator. Close monitoring should be done for at least one year because most SR in UPJS regressed spontaneously within one year.

• Clinical and Experimental Pediatrics
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• v.45 no.2
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• pp.223-231
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• 2002

Purpose : We review our experience with pyeloplasty for unilateral ureteropelvic junction obstruction of moderate to severe hydronephrosis observed by prenatal ultrasonography to assess the appropriate timing of operation for recovery of renal function and obstruction. Methods : We retrospectively reviewed the records of the total 28 patients who underwent pyeloplasty between 1995 and 2001 at Asan Medical Center. We compared pre and postoperative differentials in renal function and diuretic renogram as measured by technetium-99m-mercaptoacetyl-triglycerine scan and the degree of hydronephrosis by renal ultrasonography. Results : In all 28 patients postoperative follow-up renal ultrasonography revealed significant improvement in hydronephrosis. In 10 poorly functioning hydronephrotic kidneys in which relative renal function function was less than 35%, renal function was improved postoperatively in 3 cases, but not improved in 7 cases. In all 28 patients postoperative follow-up diuretic renogram revealed significant improvement. Conclusion : We believe that the early pyeloplasty should be considered when ultrasonography and diuretic renography suggest obstruction because renal function does not improve significantly after pyeloplasty over preoperative value.

• Childhood Kidney Diseases
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• v.16 no.2
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• pp.146-149
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• 2012

Gross hematuria is uncommon, and rarely associated with hydronephrosis in healthy children. We describe a 3-year-old boy who complained of gross hematuria and dysuria. He was diagnosed as cystitis with bilateral hydronephrosis, and treated with antibiotics and conservative therapy. Our experience suggests that cystitis with hydronephrosis can occur in healthy children presenting with gross hematuria.

• Childhood Kidney Diseases
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• v.3 no.2
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• pp.203-208
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• 1999

Purpose: The information on the change of the relative renal function after operation is essential to set the initial treatment plan in unilateral hydronephrosis. So we analyzed the preoperative and postoperative relative renal function, and observed the functional changes by operation and reliability of the various factors in those changes. Materials and Methods: A retrospective trial was done of 81 patients, 35 ureteropelvic junction(UPJ) obstruction and 46 vesicoureteral reflux(VUR), among 393 patients undergoing operations at our institution from March. 1992 to February. 1997. The patients who had infravesical abnormalities, abnormal contralateral kidney and insufficient research data were excluded. We determined the relative renal functions using DTPA and MAG3 scan in UPJ obstruction and DMSA scan in VUR. The mean observation period after operation was 2.01(0.25-4) years. Results: A. UPJ Obstruction 1. The relative renal function was improved significantly after operation(P=0.0007). 2. The kidneys which have preoperative functions between 20% and 40% improved significantly in relative renal function comparing to the kidneys of the other functions(P=0.0046). B. VUR 1. The renal functions didn't improve significantly after operation(P>0.05). 2. There was no significant factor affecting the prognosis in renal functions. Conclusions: 1. The kidneys with UPJ Obstruction show the difference in functional improvement after operation according to the degree of the preoperative renal function, but more investigations about the exact value are needed. 2. In VUR there was no difference between preoperative and postoperative functions, the theoretical basis on objectives of the operation could be the symptoms or factors except the operation.

• Clinical and Experimental Pediatrics
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• v.52 no.8
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• pp.917-921
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• 2009

Purpose : Although renal ultrasonography (USG) has improved the detection rate of hydronephrosis (HN), its clinical courses and postnatal management remains controversial. Here, we reviewed the clinical features of patients with HN according to the grades. Methods : We retrospectively studied 207 patients who were regularly followed-up among 367 patients with HN detected by renal USG postnatally between April 1998 and December 2007. These patients were grouped into four groups, grades 1-4, according to renal pelvic diameter (RPD). For analysis, each group was merged into two categories (mild: grade 1, 2; severe: grade 3, 4). Results : During follow-up, 128 episodes of urinary tract infection (UTI) occurred in 91 patients. According to grades from 1 to 4, 35/89 (39.3%), 41/88 (46.5%), 11/22 (50%), and 4/8 (50%), respectively, had UTI, without any significance between the mild and severe groups. However, the severe group presented a higher risk in cumulative episodes of UTI per year (P=0.041). The spontaneous resolution of HN was observed in 103 (58.8%) of the 175 mild group patients and in 3 (10.7%) of the 28 severe group patients (P<0.001). Furthermore, the detection rate of prenatal HN by prenatal USG was much higher in patients with severe RPD (P<0.001). Conclusion : We found that the severer the grade of HN, the lower was the rate of spontaneous resolution and higher was the frequency of UTI. Therefore, the establishment of guidelines for managing treatments such as antibiotic prophylaxis for patients with HN is needed to improve renal prognosis.

• Childhood Kidney Diseases
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• v.14 no.2
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• pp.184-194
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• 2010

Purpose : The aim of this study was to evaluate the incidence of febrile urinary tract infection (UTI) according to clinical characteristics in patients with congenital hydronephrosis (CH) and hydronephrotic patients first diagnosed with hydronephrosis during treatment of febrile UTII. Methods : In this study, 200 patients with congenital hydronephrosis were enrolled in group 1 and 252 patients first diagnosed with hydronephrosis during treatment of febrile UTI were enrolled in group 2. We counted the episodes of UTI in the two groups according to clinical characteristics, the presence of VUR, type of feeding, and clinical outcomes since 2000. And we compared those results between the two groups. and compared two groups as well. Results : The incidence of recurrent UTI was 10%, 0.028 per person-year in group 1 and 16.7%, 0.051 per person-year in group 2, respectively (P <0.05). Group 2 had more VUR (3% vs. 27%, P <0.05) and higher incidence of UTI than group 1. The incidence of UTI in patients with CH of Society of Fetal Urology (SFU) grade 4 or grade 4-5 VUR was 80% and 44.4%, respectively. No significant differences were found in incidence of UTI between BMF (breast milk feeding) and artificial milk feeding group in both groups (P 1=0.274, P 2=0.4). The time of resolution of CH had no correlation with either number of UTI episodes or the presence of VUR. Conclusion : The overall incidence of UTI is low in patients with CH as well as patients patients first diagnosed with hydronephrosis during treatment of febrile UTI except patients with SFU grade 4 or grade 4-5 VUR. BMF has no protective effect against UTI.

• Journal of Yeungnam Medical Science
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• v.15 no.1
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• pp.159-163
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• 1998

Percutaneous nephrostomy was performed using 18 guage pucture needle under ultrasonic guidance in 58 patients, 98 cases with hydronephrosis (bilateral; 15 cases, repeat nephrostomy; 25 cases). The causes of the hydronephrosis were malignancy(33 patients, 65 cases), benign diseases(18 patients, 25 cases), and unknown causes(7 patients, 8 cases). Successful nephrostomy was achieved in a11 cases. Major complication was not found, but seven(7.1%) minor complications, such as gross hematuria(four cases), perirenal urine leakage(two cases), and fever(one cases) were developed. The complication rate in our study was similar to that of other studies using 21 guage puncture needle. In conclusion, we think that the percutaneous nephrostomy using 18 guage puncture needle is a simple, safe, and cost and time effective procedure and it can replace the method using 21 guage puncture needle.

• Journal of Veterinary Clinics
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• v.28 no.3
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• pp.332-335
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• 2011

A 6-year-old castrated male domestic short hair cat with the clinical signs of anorexia and vomiting was admitted to the local animal hospital. Abdominal radiography and ultrasonography revealed renomegaly and severe hydronephrosis in the right kidney. Surgically excised right kidney was submitted for diagnosis. On the cut surface, two milky white masses and severe dilation of renal pelvis were observed. Most of the neoplastic masses were composed of uniform well differentiated tubules lined by a single layer of cuboidal to columnar cells and projected papillae into the lumen. The neoplastic cells were strong positive for cytokeratin (CK) MNF116, but negative for CK 7. Based on the clinical and gross findings, histopathology and immunohistochemistry, this case was diagnosed as papillary renal adenoma with hydronephrosis.

• Korean Journal of Veterinary Research
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• v.41 no.3
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• pp.421-427
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• 2001

This study was performed to evaluate the embolized kidney and contralateral normal kidney using computed tomography (CT) and enhanced computed tomography. Experimental hydronephrosis was induced by ligation of unilateral ureter in Beagle dogs. Renal artery embolization was performed using selective catheterization in the hydronephrotic kidney of seven dogs and EKG, $SpO_2$, body temperature, pulse, and repiratory rate were within normal ranges during procedures. Iohexol-ethanol solution was used as embolic material. There were no dogs expired after TAE-Ra and no side effects associated with regurgitation of iohexol-ehtanol solution. Revascularization of renal artery was not found in angiography in dogs treated by TAE-RA at immediately after TAE-RA and 14 days after TAE-RA. CT showed dilation of urinary collection system and ventral displacement of spleen at 14 days after TAE-RA in one dog not treated by TAE-RA and experimental group treated by TAE-Ra. CT two month after TAE-RA showed the shrunken embolized kidney in experimental group. Transverse CT with contrast enhancement demonstrated the increase of signal intensity at thinned renal cortex in control group not treated by TAE-Ra at 30 days and 60 days, however, there was no increase of signal intensity at shrunken embolized kidney at 60 days after TAE-RA. CT was useful modality for evaluation of the morphology and the size of embolized kidney and contralateral normal kidney. Enhanced CT was availabel for the detection of revascularization of renal artery after TAE-RA in dogs with hydronephrosis. It is conclued that CT is useful modality for the monitoring of the revascularization of the renal artery after TAE-RA.

• Childhood Kidney Diseases
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• v.6 no.2
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• pp.227-236
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• 2002

Purpose : A study was done to assess the incidence and classification of congenital urinary tract anomalies detected by antenatal ultrasonogram. Methods : We reviewed 558 cases of urinary tract anomaly which were detected by antenatal ultrasonogram and postnatally confirmed between June 1989 and May 2002. We investigated the incidence and classified congenital urinary tract anomalies by review of medical records, antenatal and postnatal radiologic studies retrospectively. Results : In 558 cases of congenital urinary tract anomalies, 292 cases of hydronephrosis were found and the most common. Another anomalies were composed of 65 cases of multicystic dysplastic kidney, 32 cases of hydroureteronephrosis, 31 cases of duplication of kidney, 25 cases of renal agenesis, 21 cases of simple renal cyst, 20 cases of polycystic disease, 13 cases of ureterocele, 11 cases of renal hypoplasia, 10 cases of horseshoe kidney, 9 cases of vesicoureteral reflux, 8 cases of posterior urethral valve, 7 cases of bladder diverticulum, 6 casts of megaureter, 5 cases of ectopia, 2 cases of megacystis, and 1 case of medullary cystic disease. In 82 of the 558 cases, there were two or more combined urinary tract anomalies. Associated diseases other than urinary tract were observed in 13 cases, of which the congenital heart disease was the most common. Conclusion : The congenital urinary tract anomaly is frequently found and diverse during the antenatal ultrasonography. The multicenter study is needed to investigate precise incidence and distribution of each anomalies in general population.