What is this disease?

• Prenatal diagnosis of urinary tract (UT) dilation occurs in 1-2% of all pregnancies. In the majority of the cases, the prenatal finding of UT dilation is transient or physiologic and has no clinical significance. In other cases, it represents obstructive conditions such as posterior urethral valves (PUV) that have significant morbidities and even mortalities. Fetal pyelectasis on mid-trimester ultrasound is associated with an increased risk of trisomy 21.

How it is diagnosed?

• The diagnosis is by  antenatal ultrasound(USG). An Anteroposterior renal pelvis dimension (APRPD) of 4 mm in second trimester (16-20 weeks) and more than 7 mm in third trimester (28-32 weeks) is the most common threshold for diagnosing Urinary tract  dilation. The aetiology is suspected on USG scan. However, in many of the cases, the etiology of UT dilation is unable to be determined before birth and is diagnosed postnatally with additional imaging including ultrasound (US) and voiding cystourethrogram (VCUG).

How it is treated?

• Treatment will depend upon the cause.

When it should be operated/Investigated?

• It is generally recommended that the first postnatal US be delayed for at least 48 h after birth, except for cases of oligohydramnios, urethral obstruction, bilateral high-grade dilation, and concerns about patient compliance with postnatal evaluation. Children with prenatal UT dilation, a second postnatal US should be performed even if the first postnatal US is normal.

Are there other alternative methods of treatment?

• The treatment will depend upon the cause.

What all I need to know before my child surgery?

• Read “All you need to know before your child's surgery” information booklet in website.

How is the surgery done?

• The pediatric surgeon will operate depending upon the cause.

 Remarks

• For more details of surgery, contact your surgeon

Related Tables

Few Tables giving etiology and suggested treatment protocol is  given here for learning purposes.