Question Title: kidney obstruction

Our son born 8-24- 98 was diagnosed with mild hydronephrosis in utero.
since then, reflux has been ruled out, but the lasix renogram showed
moderate obstruction of the right and mild of the left kidney. the obstruction
appeared at the kidney ureter junction. percentage was 38% right and 62% left.
recommendations were moniter every three months with lasix renogram and operate
if recurring infection or kidney damage becomes evident. I have read information from
another ped urologist that early surgery was recommended that would return any lost
kidney function and take the compensatory pressure off the left kidney. this
seem contradictory. I would appreciate any suggestions. Also he incidentally was born with
very mild hypospadia and chordee.
thank you for you time and informaiton

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Dear Mike
Thanks for your questions.
Bilateral hydronephrosis secondary to bilateral UPJ obstruction is rare. The verdict is still out with regards to early/ late operation verse observation for UPJ obstructions. Dr. King et al ,in 1984, recommend early surgery. Dr. Ransley et al , 1990, recommend surgery if function in one of the renal units is less than 40% and Drs. Koff and Campbell, 1992 recommend observation only.. Multiple genitourinary abnormalities are more common when at least one is present.
More individualized care is available at the Henry Ford Hospital and its urban campuses by calling (1 800 653 6568). We can also arrange local accommodations through this number if this is your need. Please bring any physicians’ notes and lab test results that you may be able to obtain. These will help us greatly.

This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
Sincerely;
HFHS-M.D. MS
* Keyword: hydronephrosis, ureteropelvic junction obstruction, surgical treatment for ureteropelvic junction obstruction

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