Does the treatment of hydronephrosis in children require surgery?

The article is expertly advised by MSc. Dr. Nguyen Minh Tuan - Pediatrician at the Department of Pediatrics - Neonatology - Vinmec Danang International General Hospital

Hydronephrosis is a condition in which urine flows from the kidneys to the bladder. The most common cause of hydronephrosis in children is narrowing of the junction of the kidney and the ureter. So how to treat hydronephrosis in children, does it need surgery or not?

Treatment for hydronephrosis depends on the cause and extent of the disease. However, the general goal of treatment is how to resolve the urinary obstruction in the kidney. Specific treatments include:

1. Treatment of hydronephrosis according to the cause of the disease

If there is a sudden blockage, the doctor will proceed to insert a tube through the urethra into the bladder. These catheters relieve symptoms until the patient is treated with more radical methods such as medication or surgery; If hydronephrosis is caused by kidney stones, the doctor will prescribe medication to help control the pain of kidney stones and ask the patient to increase fluid intake. Or it can also be treated with pulse wave method or laparoscopic surgery to remove too large kidney stones; If hydronephrosis is caused by an infection, your doctor may prescribe medication to help prevent urinary tract infections;

Điều trị thận ứ nước theo mức độ của bệnh

2. Treatment of hydronephrosis according to the severity of the disease

The degree of hydronephrosis is divided into 4 levels from 1 to 4 with gradual increase in size, in which grade 4 is the most severe.
For mild hydronephrosis (grades 1 and 2): the doctor conducts ultrasound to evaluate the shape of the kidneys. Children will continue to be monitored by ultrasound and periodically re-examined every 3 months. The disease is likely to improve on its own as the emptying process continues after birth until the baby is one year old; For the degree of severe hydronephrosis (grades 3 and 4): the doctor conducts a renal scan to evaluate the function and degree of obstruction to have the appropriate treatment;

3. When should surgery be needed to treat hydronephrosis in children?

Doctors will appoint surgery to treat hydronephrosis in severe cases, when there are symptoms and kidney function decreases by more than 10%. Currently, the most advanced method to treat hydronephrosis is surgery by retroperitoneal endoscopic pyelonephritis - ureteroplasty.
In summary, treatment of hydronephrosis in children depends on the cause and extent of the disease. Surgical method will be indicated when the degree of hydronephrosis is severe.

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