Hydronephrosis in Infants

Hydronephrosis in children, is a condition that is not so common and parents aren't really aware of it usually. This may be because, most of the time, mild cases get resolved on their own. Anyway, this can be a serious condition, so diagnosing and treating it is essential. Hydronephrosis in infants is basically a condition where the kidney (one or both) gets expanded or stretched due to collection of urine. This collection of urine is due to a particular blockage that does not let the urine flow into the kidney(s) or even out of the kidney(s). The more appropriate term here would be bladder. This blockage leads to urine collection in the kidneys and when the kidney(s) is overfilled, we experience hydronephrosis. There are many hydronephrosis causes and we shall check them out in this Buzzle article along with their treatment.

Kidney Conditions You Need to Know About

Before we discuss kidney conditions, let me tell you a few common symptoms of hydronephrosis, usually present in infants. Most of the symptoms are not observed in mild and moderate cases. However, if the case is severe, you might notice symptoms such as urinary tract infections, back pain, fever, cloudy urine and painful urination.

Ureteropelvic Junction Obstruction
Ureteropelvic junction is where the kidney and the ureter meet. This obstruction is one of the most common causes of hydronephrosis in children. There might be signs such as swelling of the ureter or the pelvic region.

Vesico-ureteral Reflux
This condition is experienced when there is a backwash of urine. This means that there is a backflow of sorts from the bladder. The signs of this cause of hydronephrosis can be a changing or differing degrees of hydronephrosis between exams.

Ureterocele
This is a cystic end of the ureter that may obstruct both, the ureter and the bladder. This end of the ureter may lie in the bladder to an extent that it can obstruct it. The symptoms of this kind of hydronephrosis, will be presence of a structure observed in the bladder along with hydronephrosis.

Posterior Urethral Valves
This means the existence of abnormal tissue flaps in the urethra. This condition can be diagnosed in ultrasound readings where we can find a bilateral kidney, bladder and ureteral dilation. Sometimes, it can be accompanied by decrease in the amniotic fluid level also termed as oligohydramnios.

Ectopic Ureter
This condition is also to do with the abnormal tissue flaps in the urethra. However, this cause of hydronephrosis will show symptoms such as hydronephrosis of the ureter. This hydronephrosis is usually observed in the upper part of the kidney.

Treatment for Hydronephrosis in Infants

Treatment for hydronephrosis depends on the intensity and severity of the hydronephrosis. If the condition is mild, the child may just be monitored and receive no treatment as in most cases the problem is solved on its own. However, this can be decided only be the doctor. It is strictly advised to not treat on self diagnosis. If the problem is of more gravity, then the doctor might prescribe antibiotics. However, if the problem is really severe, you might have to go in for a surgery. More details about the surgery are discussed below.

Before the nature of treatment is decided, the doctor might ask your child to go through the following tests.

• Voiding cystourethrogram (VCUG)
• Renal ultrasound (RUS)
• A renal scan (MAG 3 with lasix)
• Intravenous polygram (IVP)

If the fetus is found to be at risk, the doctors might ask you to go in for a hydronephrosis surgery in infants. Fetal intervention is a surgery performed by doctors where they use ultrasound guidance and place a vesicoamniotic shunt in the fetus's bladder. This shunt drains the bladder by bypassing the urethral obstruction. The urine then flows into the amniotic space. A treatment similar to the amniocentesis is considered most reliable. There are more details to this surgery and of course it has its risks. Ask your doctor about the risks as they are different in each case.

Now that you know everything about hydronephrosis in infants and all the hydronephrosis facts, you can discuss with your doctor if you see any hydrophrosis symptoms mentioned above. Mostly, you will be asked to take your child for one of the tests. After the results, depending on the severity of the condition, you can decide the type of treatment with your doctor. It is always advised to go for routine check ups so problems such as hydronephrosis can be detected and cured at the initial stages.