Treatment for Antenatal Hydronephrosis

This condition is usually managed by carefully observing kidney growth and function throughout the pregnancy by ultrasound. Low-dose antibiotics may be administered to prevent infection.

Cases of moderate or severe antenatal hydronephrosis may require a surgical procedure to drain urine and prevent kidney damage. Surgery to treat a blockage (called pyeloplasty) has a success rate of 90–95 percent. However, in many cases (even moderate to severe cases), the condition resolves and does not result in kidney damage. Carefully monitoring kidney growth and function is the preferred treatment unless surgery proves necessary.

After birth, infants continue to require monitoring. Ultrasound is performed to assess kidney function. A cystogram may be performed to determine if urine is backing up into the kidney (reflux). In this procedure, a small tube is inserted through the urethra into the bladder. A contrast agent (dye) is instilled through the tube into the bladder and x-rays are used to detect reflux. Other tests may be performed to assess the function of both kidneys.

In cases of multicystic kidney, the other kidney is usually normal. Removal of the non-functioning kidney is not required unless complications (e.g., tumor, blockage, excessive size) develop.

Kidney function in patients with this condition must be regularly monitored (usually by ultrasound performed every 6 months) throughout childhood.

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 09 Jun 1998

Last Modified: 01 Sep 2015