Q: My 2-month-old son is suffering from hydronephrosis. The problem was identified by ultrasound scan in the 6th month of pregnancy. The report said bilateral hydronephrosis, mild on right kidney, gross in left kidney with PUJ obstruction. The ultrasound scan after 4 days of delivery still showed the same. Recent ultrasound scan after 1.5 months says right kidney is normal in size and left kidney size is 92 x 68 mm. We did MCUG and DTPA tests for my child recently. MCUG report shows every thing normal. DTPA report shows that functioning of the left kidney is 10-15%. Doctors are advising to do Pyeloplasty. I am very tense for the past 6 months. Is it safe to do Pyeloplasty on a 2-month-old child? What are the risks involved? Can't we rectify this fault without surgery? Will surgery cure the problem completely? Will both kidneys function normally after the surgery? Will there be any side effects in future? Can the child participate in outdoor games and activities, which require physical strain? Do we have to take any precautions like in food and other habits? Which surgery, open pyeloplasty or laparoscopic, is preferable?

A:Question of doing Pyeloplasty on a 2-month-old child is not so much of safety, but need. There is no other treatment or choice that you have. It must be done and it is reasonably safe in competent hands. The risks involved are of any standard operation. If done in a centre that routinely handles babies of this age, there are no major worries. No, this fault cannot be rectified without surgery. Surgery corrects the fault in 98% of cases. The right kidney will be normal. The left will never be completely normal. The aim of the operation is to protect against further damage to the left kidney. There are no side effects and the child can have a normal lifestyle. The child can most certainly participate in outdoor games and activities that require physical strain. There is no need to take any future precautions. There is no doubt in my mind that the best technique today is still the standard open operation and not laparoscopy.