Weill Cornell Medicine Urology
Weill Cornell Medicine Urology
Prenatal Hydronephrosis - Risks & Causes

Prenatal Hydronephrosis - Risks & Causes

The most common cause of fetal hydronephrosis is ureteropelvic junction (UPJ) obstruction. This finding is characterized by varying degrees of renal pelvic dilation. The most common cause of UPJ obstruction is an intrinsic narrowing of the proximal ureter. This narrowing can be likened to a scar or stricture in the ureter as it leaves the kidney. Sometimes, the ureter can be obstructed behind a band of tissue or a blood vessel supplying the lower segment of the kidney. This entity is known as a "crossing vessel".

When a dilated ureter is detected along with the renal pelvis, the working diagnosis is vesicoureteral reflux or uretero-vesical junction obstruction. Males with significant hydroureteronephrosis occurring simultaneously with a large thin walled bladder and normal renal parenchyma will often have a condition of massive reflux known as megacystis-megaureter.

Prenatal findings of hydroureteronephrosis can be associated with other diagnoses such as posterior urethral valves, prune-belly syndrome, or duplication anomalies such as ectopic ureter or ureterocele.

The diagnosis of posterior urethral valves is reached when a male fetus has the following findings:

  • Bilateral hydroureteronephrosis
  • Thick-walled, moderately dilated bladder
  • Dilated posterior urethra
  • Kidney architectural changes, and
  • Diminished volumes of amniotic fluid.

Other genitourinary diagnoses that can be made prenatally include renal dysplasia, multicystic dysplasia, renal agenesis, renal hypoplasia, renal cystic disease, bladder/cloacal exstrophy, and external genital anomalies.

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Dr. Dix Phillip Poppas, M.D., F.A.A.P., F.A.C.S. | Cornell Urology

Dix P. Poppas

M.D., F.A.C.S., F.A.A.P.

212.746.5337
212.746.5337
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The Institute for Pediatric Urology

Ardavan Akhavan

M.D.

212.746.5361
212.746.5361
Aetna-Weill Cornell POS, Blue Priority Network, EBCBS HMO, EBCBS Mediblue, EBCBS Pathway X, EBCBS Pathway X Enhanced, EBCBS PPO/EPO, Fidelis Care, Health First, Medicaid, Medicare, Rockefeller University-CoreSource
The LeFrak Center for Robotic Surgery
Dr. Jeremy B. Wiygul, M.D. | Cornell Urology

Jeremy Wiygul

M.D.

(718) 224-2644
(718) 224-2644
AETNA, AETNA [Medicare], AETNA-HMO, AETNA-PPO, Aetna-Weill Cornell POS, Affinity (Exchange Products: Essential- Platinum, Gold, Silver, Broze, American Indian, Catastrophic), Affinity Access, Affinity Essential, Affinity Health Plan, Amida Care, CIGNA, EBCBS HMO, EBCBS Mediblue, EBCBS NYPH Employees Only, EBCBS Pathway X, EBCBS Pathway X Enhanced, EBCBS PPO/EPO, Elderplan, Empire BCBS HealthPlus (CHP), Empire BCBS HealthPlus (Medicaid), Empire Plan, Fidelis (Medicare, Medicaid & CHP ), GHI, GHI PPO/CBP/Prem PPO (Emblem Exchange Products: Select Care Bronze, Silver, Gold, Platinum, Basic), Health First (Medicare, Medicaid, FIDA, CHP, Exchange and Essential Plans), Health Insurance Plan of NY (HIP), Health Insurance Plan of NY (HIP) [Medicaid], Health Insurance Plan of NY (HIP) [Medicare], Healthcare Partners (Commercial, Medicaid, Medicare only underwritten by HIP), HIP (Incl. Comprehealth) (Emblem Exchange Products: Select Care Bronze, Silver, Gold, Platinum, Basic), MagnaCare (PPO, Direct Plus), MultiPlan, Oxford (NY State of Health), Oxford Freedom, Oxford Health Plans [Liberty], Oxford Health Plans [Medicare], Oxford Health Plans [Metro/Core/Charter], Oxford Medicare, UHC Community Plan - Medicaid Plan, UHC Compass, UHC Compass-HMO, UHC Medicare, United Health Care, United Health Care [Community Plan], United Healthcare Commercial, VNSNY CHOICE Medicare, VNSNY CHOICE SelectHealth, VNSNY Choice/VNS FIDA (formerly Select Health), Wellcare (Medicare, Medicaid, CHP)
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