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What the best can I do for my child diagnosed with grade 4 hydronephrosis with left PUJO ?

By Anonymous November 15, 2010 - 1:27am
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My child is aged 5.5 years. She has been operated for complete left PUJO on 17-07-10. Fresh reports say that the drainage is still obstructed. EC Scan shows relative function of lt. kidney at 90 % and rt. kidney 10%. Right kidney is shrunken (3.3 cms) and left kidney pre-operative was 11.9cms and post operative, it is 9.9 cms. I/V test pending for 22-11-10.

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While we wait for an expert to respond, I wanted to provide some information, and learn more about how your daughter is doing.

What specific type of operation did she have, for instance: laparoscopic pyeloplasty, open pyeloplasty, endopyelotomy, endopyeloplasty, or robotic-assisted laparoscopic pyeloplast?

According to, eMedicine: UPJ Obstruction follow up,"open and laparoscopic pyeloplasty yield long-term success rates that exceed 95%. The success rate for endopyelotomy approaches 80-90%."

According to, Ureteropelvic Junction Obstruction, Causes, Treatment - Pediatric Urology - Urology Channel,
"Patients require follow-up care for several years following pyeloplasty. Tests to evaluate kidney function are performed regularly (6 months to 1 year).

UPJ Obstruction Prognosis
The success rate for patients who undergo pyeloplasty is higher than 95%.

Prevention of UPJ Obstruction
Ureteropelvic junction obstruction cannot be prevented."

What have her own doctors told you about her recovery, and any future operations that may be needed? Did they provide information about further surgery or medications to help with drainage? I also read that imaging results may be different than actual functioning of the kidneys, and although an Xray may show blockage, if the kidney is draining properly, no treatment would be suggested, and patient would be monitored.

Is this a congenital condition, or is there another known cause?

You can find some helpful information:
- Childrens Hospital Boston: Hydronephrosis
- ureteropelvic junction (UPJ) obstruction (also known as pelviureteric junction obstruction (PUJO))
UPJ Obstruction: Treatment
- UPJ Obstruction: Follow Up

November 16, 2010 - 1:58pm
EmpowHER Guest
Anonymous (reply to Alison Beaver)

Respected Sir/ Madam,
In continuance of and in reference of “What the best can I do for my 5.5 year old daughter suffering from grade IV hydronephrosis with left PUJO” I am sending reports of my daughter for your kind perusal and opinion. Please tell whether the patients suffering with hydronephrosis of IV grade should be given a lot of water or not?
Urea 26 Creatinine 0.9

-Both kidneys show prompt excretion of contrast. However there is e/o faint nephrogram on (r) side, which is poorly seen.
-Both kidneys appear normal in location, LK is bulky.
-(R) PCs is not visualized. (R) ureter is visualized in its upper and mid part and appears (n) in caliber and outline.
-There is e/o ballooning of (L) PCS with non-visualization of (L) ureter.
-After IV Lasix injection, there is persistence of contrast in (L) PCS on 20 min post lasix image.
-Urinary bladder is (N) in shape distention and outline.
-Faint (R) nephrogram
-Status (L) pyeloplasty with gross (c) hydronephrosis with obstructed drainage.

November 27, 2010 - 12:28am
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