Objective:

The need for surgery in high-grade hydronephrosis should be discussed in the literature. We evaluated the necessity of surgical treatment and follow-up results in cases with high grade antenatal hydronephrosis which may be due to ureteropelvic junction obstruction.

Methods:

Between 2010 and 2017, 79 (M: 62, F: 17) high grade antenatal hydronephrosis was followed by serial MAG3 scintigraphy, urinary ultrasound. The cases are, 10% or more loss of function, low functioning (<40%) obstruction at initial evaluation, no loss of function and increased hydronephrosis, non-obstructive hydronephrosis, resolution group. Pelvic AP diameter, parenchymal thickness were compared between the surgical and non-surgical groups.

Results:

Pelvic AP diameter function was lost and did not lose function but increased with hydronephrosis and it was significantly higher than the non-obstructive group in the surgical group (p=0.009, p=0.008). Parenchyma thickness was significantly lower in the surgical group than in the follow-up group. Pelvic AP was found as predictive ultrasonographic parameters for the surgery, 28 mm above the diameter and 5.8 mm below the parenchyma thickness.

Conclusion:

High-grade hydronephrosis is a concern for both the family physician and the physician. We think it would be useful to use these findings in informing the family.