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How to confirm hydronephrosis in young children?

Q: My son is one month old. During my wife's pregnancy, the baby was detected to have mild bilateral hydronephrosis. At that time doctors told us to wait for the delivery. After birth two ultrasounds have been conducted and they have confirmed that there is mild assymetrical bilateral renal hydronephrosis. Urine/blood exam are normal for the baby. Ureters are normal and the same is true for urinary bladder. Child is passing urine at normal frequency and quantity. An ultrasound has suggested that the size of cortex is 8-9mm in both kidneys. Right renal volume is 15 cc and left renal volume is 14 cc. Whether it is extrarenal baggy pelvis or some obstruction is there? Some doctors have suggested IVP whereas others say that it is dangerous for kids and DMSA & DTPA should be conducted. One has also suggested MCU test. Please tell the future course of action. Which test should be conducted and whether it would be safe for a month old child? Which is the best place in north india for this problem? Which specialist takes care of these kind of problems? Is this problem curable? Please guide me as I am very much troubled.

A:I have gone through your sons report. Your son needs DTPA & DMSA scan and urine culture and urine routine examination. You can get these done in Delhi either at Apollo Hospital, Gangaram Hospital or AIIMS. The above tests are essential for follow up as well and need to be seen in nephrology/urology services. One needs to first make an assessment and diagnosis before one can talk about the cure or risk.


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