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Is operation for hydronephrosis in a young child necessary?

Q: My 2 and a half months old son has hydronephrosis. It was detected during the 8th month of pregnancy. Two months after delivery sonography confirmed mild hydronephrosis. IVP and MCU tests done show obstruction in VIJJ area and swelling in the nephron tube. Kidney, ureter and bladder are OK. Doctor suggests an operation in three months. Is this operation safe for such a small child? Are there any other alternatives to it?

A:I think the information that you have given is good enough to give an opinion. A majority of mild hydronephrosis due to VU junction obstruction DO NOT need surgery as they usually stabilize. Surgery is indicated only if the hydronephrosis/hydroureter is increasing, or the kidney function shows evidence of deterioration. You really need to have a good opinion with review of all the films before you plan for surgery. Meanwhile, it may be a good idea to get a DTPA renal scan done.


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