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PAEDIATRIC UROLOGY

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5. DILATATION OF THE UPPER URINARY TRACT

5.1 BACKGROUND

Hydronephrosis is detectable within the uterus by ultrasound from the 16th week of pregnancy. The commonest causes are ureteropelvic junction (UPJ)-stenosis, megaureters, urethral valve syndrome, vesicorenal reflux and multicystic renal dysplasia.

5.2 DIAGNOSIS

5.2.1 Ultrasound examination

Ectasia (anterior-posterior diameter of the renal pelvis, caliceal ectasia), kidney size, thickness of the parenchyma, cortical echo-pattern, width of the ureter, bladder wall thickness and residual urine are assessed during ultrasound examination. With a diameter of the renal pelvis greater than 15 mm, obstruction of the upper urinary tract is likely and correction may be considered. The first ultrasound examination of prenatally diagnosed ectasia of the renal pelvis should be carried out within the first 2 days of life, after 3-5 days and after 3 weeks. A normal ultrasound during the first days of life can be secondary to the oliguria of the newborn.