Hydronephrosis

Hydronephrosis refers to fluid accumulation in the kidneys, often detected through ultrasound, whether pre or post-birth. The kidneys process waste from blood into urine, which should flow through the ureter to the bladder and be voided. However, factors can lead to urine accumulation in the kidney. While fluid in the kidney doesn't necessarily signal a problem (often resolving naturally), it's vital to monitor for potential concerns like ureteropelvic junction (UPJ) and ureterovesical junction (UVJ) obstructions, ensuring timely intervention if needed.

Ureteropelvic Junction (UPJ) obstruction

The UPJ (ureteropelvic junction) connects the kidney and ureter. Fluid buildup in the kidney but not the ureter may signal scarring, hindering urine drainage and leading to pressure, potential kidney damage, or infection risk. An ultrasound may prompt a nuclear test to identify obstruction, potentially requiring pyeloplasty surgery under anesthesia. This procedure removes scarred parts and reattaches the ureter for improved drainage. Post-surgery, a hospital stay of about one night is common before discharge.

Ureterovesical Junction (UVJ) Obstruction

Similar to UPJ obstruction, the UVJ (ureterovesical junction) blockage occurs at the connection between the ureter and the bladder. If fluid accumulates in both the kidney and ureter, scarring may be present at the ureter-bladder junction. This can lead to fluid back-up, kidney pressure, and stagnant urine, elevating UTI risk. Detecting obstruction might necessitate surgical intervention called ureteral re-implant, performed under general anesthesia. The scarred bladder-connected ureter segment is excised and reattached, enabling proper drainage. Following surgery, patients usually spend one night in the hospital before discharge.