(Stenosis in the Kidney Outflow) There is stenosis at the junction of the kidney chamber and the urinary tract. In this case, the urine produced cannot pass into the ureter and bladder easily and accumulates in the kidney. It is the most common urinary anomaly during pregnancy. It is the most common place for obstruction in the urinary system. Unilateral hydronephrosis is usually not a life-threatening condition. However, follow-up and treatment are more serious in babies with bilateral problems.
Diagnosis: In most cases, the diagnosis is made by ultrasound performed during pregnancy before birth. It usually does not cause any complaints after birth. In babies, it can be noticed by the family or physician as asymmetry and a soft mass in the baby's abdomen. Older children may present with side pain. Sometimes it can be detected incidentally during other examinations. Diagnosis is usually made by ultrasound. While the bladder and ureter (urinary duct) appear normal on ultrasound, only enlargement (hydronephrosis) is detected in the kidney. It may be necessary to take scintigra to detect kidney damage in patients with excessive enlargement of the kidney.
Treatment Treatment is generally planned according to the degree of hydronephrosis detected on urinary ultrasound, kidney damage detected in scintigra, the presence of urinary infection and whether the hydronephrosis is single or double-sided. In mild and moderate ureteropelvic junction stenosis in babies, the problem may resolve spontaneously over time with normal development in these areas. However, if the child has complaints such as pain, urinary infection or stones, surgery should be performed. In babies with no complaints, if kidney deterioration or kidney damage develops during ultrasound follow-ups, surgery is required. During the surgery, the narrow area at the kidney outlet is removed and the mouth of the wide kidney chamber and the mouth of the normal urinary tract are stitched together. Thus, the urine produced by the kidney easily passes into the urinary tract and bladder.
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