Editing CUA: Antenatal hydronephrosis (2017) (section)

== Indications for surgery in Obstructive Hydronephrosis and Hydroureteronephrosis ==

* Appropriate counselling of families should include a discussion of the risks of observation vs. immediate surgery.
* '''<span style="color:#ff0000">Strong indications for reconstructive surgery include (2):'''
*# '''<span style="color:#ff0000">Loss of differential renal function of >5% on serial renography'''
*# '''<span style="color:#ff0000">Worsening hydronephrosis with worsening drainage times on renography'''
*#* In older children, flank pain or vomiting are also suggestive of obstruction, especially if exacerbated by fluid intake. Hypertension and renal calculi can rarely be signs of obstruction.
* '''Relative indications for surgery (5):'''
*# '''UTI'''
*# '''Low differential renal function on initial renogram'''
*# '''Palpable giant HN'''
*# Concern over '''non-compliance with follow-up imaging protocols'''
*# '''Family preference''' in cases of persistent HGHN requiring repeated renographic evaluation
* '''Threshold for surgical intervention is lowered in cases of solitary kidney or bilateral HGHN'''