Weill Cornell Medicine Urology
Weill Cornell Medicine Urology
Prenatal Hydronephrosis - Symptoms & Evaluation

Prenatal Hydronephrosis - Symptoms & Evaluation

The first important step in managing patients with prenatal findings of decreased amniotic fluid, genital malformations, or other serious anomalies is to have the child treated in a tertiary care center for delivery and management of neonatal issues. Upon delivery, a directed physical examination is important to rule out associated anomalies. A newborn ultrasound will be performed at a minimum of 48 hours of life to one month. Depending on these results, the urologist may order an x-ray test called a VCUG, which involves instilling dye into the bladder and taking x-rays while the child empties the bladder. This test helps to look for bladder abnormalities and the presence of urinary reflux.

In most cases, postnatal evaluation can be performed on an outpatient basis. Children with moderate degrees of prenatal hydronephrosis can be discharged home on amoxicillin with no further inpatient evaluation. Generally an ultrasound is not performed in the first two days of life, as the neonate is usually dehydrated, creating the potential to underestimate hydronephrosis. The first ultrasound can be performed after 3-4 weeks on an elective basis while the child continues antibiotic prophylaxis.

When the postnatal ultrasound reveals severe pelvic dilation (over 1.2 cm) and caliectasis, diuretic renography is needed to assess the degree of renal obstruction and to assess renal function. Ideally, the renography is performed after the infant is at least one month of age. 99mTc MAG-3 is the radionuclide agent of choice.

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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
AETNA-HMO, AETNA-PPO, Aetna-Weill Cornell POS, Affinity Essential, Affinity Health Plan, Blue Priority Network, CIGNA, EBCBS HMO, EBCBS Pathway X, EBCBS Pathway X Enhanced, EBCBS PPO/EPO, Empire BCBS HealthPlus, Empire BCBS HealthPlus (CHP), Fidelis Care, Health First, Health Insurance Plan of NY (HIP) [Medicaid], Medicaid, Medicare, Oxford Freedom, POMCO, Rockefeller University-CoreSource, VNSNY CHOICE SelectHealth
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, Affinity (Exchange Products: Essential- Platinum, Gold, Silver, Broze, American Indian, Catastrophic), Amida Care, CIGNA, Consumer Health Network (CHN), Coventry/FirstHealth, EBCBS Pathway X, EBCBS Pathway X Enhanced, Elderplan, Empire BCBS Healthplus (AmeriGroup NY), Fidelis (Excluding Fidelis Exchange and Essential), GHI PPO/CBP/Prem PPO (Emblem Exchange Products: Select Care Bronze, Silver, Gold, Platinum, Basic), Health First (Excluding Leaf Products), HIP (Incl. Comprehealth) (Emblem Exchange Products: Select Care Bronze, Silver, Gold, Platinum, Basic), Local 1199, MagnaCare (Exchange Products: Health Republic Essenital Care, Oscar Edge Plans), Medicare, MultiPlan, Oxford (NY State of Health), Railroad Medicare, United Health Care [Community Plan], VNSNY Choice/VNS FIDA (formerly Select Health), Wellcare (Medicare, Medicaid, CHP, and FHP-exclusing Essential Plan)
Weill Cornell Medicine Urology - Queens

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