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Erschienen in: The Indian Journal of Pediatrics 7/2017

03.05.2017 | Review Article

Is it Always Necessary to Treat an Asymptomatic Hydronephrosis Due to Ureteropelvic Junction Obstruction?

verfasst von: Yogesh Kumar Sarin

Erschienen in: Indian Journal of Pediatrics | Ausgabe 7/2017

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Abstract

The postnatal treatment of asymptomatic unilateral hydronephrosis due to ureteropelvic junction obstruction remains controversial, and the timing of and indications for surgical intervention are continuously debated. There is no consensus on the best follow-up during expectant management. The various modalities and parameters have been discussed along with their pros and cons and an attempt has been made to clear up the controversies.
Literatur
1.
Zurück zum Zitat King L, Coughlin P, Bloch EC, Bowie JD, Ansong K, Hanna MK. The case for immediate pyeloplasty in the neonate with ureteropelvic junction obstruction. J Urol. 1984;132:725–8.PubMed King L, Coughlin P, Bloch EC, Bowie JD, Ansong K, Hanna MK. The case for immediate pyeloplasty in the neonate with ureteropelvic junction obstruction. J Urol. 1984;132:725–8.PubMed
2.
Zurück zum Zitat Koff SA, Campbell KD. The nonoperative management of unilateral neonatal hydronephrosis: natural history of poorly functioning kidneys. J Urol. 1994;152:593–5.PubMed Koff SA, Campbell KD. The nonoperative management of unilateral neonatal hydronephrosis: natural history of poorly functioning kidneys. J Urol. 1994;152:593–5.PubMed
3.
Zurück zum Zitat Ulman I, Jayanthi VR, Koff SA. The long-term followup of newborns with severe unilateral hydronephrosis initially treated nonoperatively. J Urol. 2000;164:1101–5.CrossRefPubMed Ulman I, Jayanthi VR, Koff SA. The long-term followup of newborns with severe unilateral hydronephrosis initially treated nonoperatively. J Urol. 2000;164:1101–5.CrossRefPubMed
4.
Zurück zum Zitat Chertin B, Pollack A, Koulikov D, et al. Conservative treatment of ureteropelvic junction obstruction in children with antenatal diagnosis of hydronephrosis: lessons learned after 16 years of follow-up. Eur Urol. 2006;49:734–8.CrossRefPubMed Chertin B, Pollack A, Koulikov D, et al. Conservative treatment of ureteropelvic junction obstruction in children with antenatal diagnosis of hydronephrosis: lessons learned after 16 years of follow-up. Eur Urol. 2006;49:734–8.CrossRefPubMed
5.
Zurück zum Zitat Onen A. Treatment and outcome of prenatally detected newborn hydronephrosis. J Pediatr Urol. 2007;3:469–76.CrossRefPubMed Onen A. Treatment and outcome of prenatally detected newborn hydronephrosis. J Pediatr Urol. 2007;3:469–76.CrossRefPubMed
6.
Zurück zum Zitat Dhillon HK. Prenatally diagnosed hydronephrosis: the great Ormond street experience. Br J Urol. 1998;81:39–44.CrossRefPubMed Dhillon HK. Prenatally diagnosed hydronephrosis: the great Ormond street experience. Br J Urol. 1998;81:39–44.CrossRefPubMed
7.
Zurück zum Zitat Onen A. An alternative grading system to refine the criteria for severity of hydronephrosis and optimal treatment guidelines in neonates with primary UPJ-type hydronephrosis. J Pediatr Urol. 2007;3:200–5.CrossRefPubMed Onen A. An alternative grading system to refine the criteria for severity of hydronephrosis and optimal treatment guidelines in neonates with primary UPJ-type hydronephrosis. J Pediatr Urol. 2007;3:200–5.CrossRefPubMed
8.
Zurück zum Zitat Thorup J, Mortensen T, Diemer H, Johnsen A, Nielsen OH. The prognosis of surgically treated congenital hydronephrosis after diagnosis in utero. J Urol. 1985;134:914–7.PubMed Thorup J, Mortensen T, Diemer H, Johnsen A, Nielsen OH. The prognosis of surgically treated congenital hydronephrosis after diagnosis in utero. J Urol. 1985;134:914–7.PubMed
9.
Zurück zum Zitat Cartwright PC, Duckett JW, Keating MA, et al. Managing apparent ureteropelvic junction obstruction in the newborn. J Urol. 1992;148:1224–8.PubMed Cartwright PC, Duckett JW, Keating MA, et al. Managing apparent ureteropelvic junction obstruction in the newborn. J Urol. 1992;148:1224–8.PubMed
10.
Zurück zum Zitat Ylinen E, Ala-Houhala M, Wikström S. Outcome of patients with antenatally detected pelviureteric junction obstruction. Pediatr Nephrol. 2004;19:880–7.PubMed Ylinen E, Ala-Houhala M, Wikström S. Outcome of patients with antenatally detected pelviureteric junction obstruction. Pediatr Nephrol. 2004;19:880–7.PubMed
11.
Zurück zum Zitat Wollenberg A, Neuhaus TJ, Willi UV, Wisser J. Outcome of fetal renal pelvic dilatation diagnosed during the third trimester. Ultrasound Obstet Gynecol. 2005;25:483–8.CrossRefPubMed Wollenberg A, Neuhaus TJ, Willi UV, Wisser J. Outcome of fetal renal pelvic dilatation diagnosed during the third trimester. Ultrasound Obstet Gynecol. 2005;25:483–8.CrossRefPubMed
12.
Zurück zum Zitat Hashim H, Woodhouse CRJ. Ureteropelvic junction obstruction. Eur Urol Suppl. 2012;11:S25–32.CrossRef Hashim H, Woodhouse CRJ. Ureteropelvic junction obstruction. Eur Urol Suppl. 2012;11:S25–32.CrossRef
13.
Zurück zum Zitat Pates JA, Dashe JS. Prenatal diagnosis and management of hydronephrosis. Early Hum Dev. 2006;82:3–8.CrossRefPubMed Pates JA, Dashe JS. Prenatal diagnosis and management of hydronephrosis. Early Hum Dev. 2006;82:3–8.CrossRefPubMed
14.
Zurück zum Zitat Nguyen HT, Herndon CD, Cooper C, et al. The Society for Fetal Urology consensus statement on the evaluation and management of antenatal hydronephrosis. J Pediatr Urol. 2010;6:212–31.CrossRefPubMed Nguyen HT, Herndon CD, Cooper C, et al. The Society for Fetal Urology consensus statement on the evaluation and management of antenatal hydronephrosis. J Pediatr Urol. 2010;6:212–31.CrossRefPubMed
15.
Zurück zum Zitat Subramaniam R, Kouriefs C, Dickson AP. Antenatally detected pelvi-ureteric junction obstruction: concerns about conservative management. BJU Int. 1999;84:335–8.CrossRefPubMed Subramaniam R, Kouriefs C, Dickson AP. Antenatally detected pelvi-ureteric junction obstruction: concerns about conservative management. BJU Int. 1999;84:335–8.CrossRefPubMed
16.
Zurück zum Zitat Arora S, Yadav P, Kumar M, et al. Predictors for the need of surgery in antenatally detected hydronephrosis due to UPJ obstruction--a prospective multivariate analysis. J Pediatr Urol. 2015;11:248.e1–5.CrossRef Arora S, Yadav P, Kumar M, et al. Predictors for the need of surgery in antenatally detected hydronephrosis due to UPJ obstruction--a prospective multivariate analysis. J Pediatr Urol. 2015;11:248.e1–5.CrossRef
17.
Zurück zum Zitat Eskild-Jensen A, Munch Jørgensen T, Olsen LH, Djurhuus JC, Frøkiaer J. Renal function may not be restored when using decreasing differential function as the criterion for surgery in unilateral hydronephrosis. BJU Int. 2003;92:779–82.CrossRefPubMed Eskild-Jensen A, Munch Jørgensen T, Olsen LH, Djurhuus JC, Frøkiaer J. Renal function may not be restored when using decreasing differential function as the criterion for surgery in unilateral hydronephrosis. BJU Int. 2003;92:779–82.CrossRefPubMed
18.
Zurück zum Zitat Fernbach SK, Maizels M, Conway JJ. Ultrasound grading of hydronephrosis: introduction to the system used by the Society for Fetal Urology. Pediatr Radiol. 1993;23:478–80.CrossRefPubMed Fernbach SK, Maizels M, Conway JJ. Ultrasound grading of hydronephrosis: introduction to the system used by the Society for Fetal Urology. Pediatr Radiol. 1993;23:478–80.CrossRefPubMed
19.
Zurück zum Zitat Keays MA, Guerra LA, Mihill J, et al. Reliability assessment of Society for Fetal Urology ultrasound grading system for hydronephrosis. J Urol. 2008;180:1680–2.CrossRefPubMed Keays MA, Guerra LA, Mihill J, et al. Reliability assessment of Society for Fetal Urology ultrasound grading system for hydronephrosis. J Urol. 2008;180:1680–2.CrossRefPubMed
20.
Zurück zum Zitat Cost GA, Merguerian PA, Cheerasarn SP, Shortliffe LM. Sonographic renal parenchymal and pelvicaliceal areas: new quantitative parameters for renal sonographic followup. J Urol. 1996;156:725–9. Cost GA, Merguerian PA, Cheerasarn SP, Shortliffe LM. Sonographic renal parenchymal and pelvicaliceal areas: new quantitative parameters for renal sonographic followup. J Urol. 1996;156:725–9.
21.
Zurück zum Zitat Imaji R, Dewan PA. Calyx to parenchyma ratio in pelvi-ureteric junction obstruction. BJU Int. 2002;89:73–7.CrossRefPubMed Imaji R, Dewan PA. Calyx to parenchyma ratio in pelvi-ureteric junction obstruction. BJU Int. 2002;89:73–7.CrossRefPubMed
22.
Zurück zum Zitat Shapiro SR, Wahl EF, Silberstein MJ, Steinhardt G. Hydronephrosis index: a new method to track patients with hydronephrosis quantitatively. Urology. 2008;72:536–8.CrossRefPubMed Shapiro SR, Wahl EF, Silberstein MJ, Steinhardt G. Hydronephrosis index: a new method to track patients with hydronephrosis quantitatively. Urology. 2008;72:536–8.CrossRefPubMed
23.
24.
Zurück zum Zitat Mudrik-Zohar H, Meizner I, Bar-Sever Z, Ben-Meir D, Davidovits M. Prenatal sonographic predictors of postnatal pyeloplasty in fetuses with isolated hydronephrosis. Prenat Diagn. 2015;35:142–7.CrossRefPubMed Mudrik-Zohar H, Meizner I, Bar-Sever Z, Ben-Meir D, Davidovits M. Prenatal sonographic predictors of postnatal pyeloplasty in fetuses with isolated hydronephrosis. Prenat Diagn. 2015;35:142–7.CrossRefPubMed
25.
Zurück zum Zitat Chipde SS, Lal H, Gambhir S, et al. Factors predicting improvement of renal function after pyeloplasty in pediatric patients: a prospective study. J Urol. 2012;188:262–5.CrossRefPubMed Chipde SS, Lal H, Gambhir S, et al. Factors predicting improvement of renal function after pyeloplasty in pediatric patients: a prospective study. J Urol. 2012;188:262–5.CrossRefPubMed
26.
Zurück zum Zitat O’Reilly PH, Testa HJ, Lawson RS, Farrar DJ, Charlton EE. Diuresis renography in equivocal urinary tract obstruction. Br J Urol. 1978;50:76–80.CrossRefPubMed O’Reilly PH, Testa HJ, Lawson RS, Farrar DJ, Charlton EE. Diuresis renography in equivocal urinary tract obstruction. Br J Urol. 1978;50:76–80.CrossRefPubMed
27.
Zurück zum Zitat O'Reilly PH; Consensus Committee of the Society of Radionuclides in Nephrourology. Standardization of the renogram technique for investigating the dilated upper urinary tract and assessing the results of surgery. BJU Int. 2003;91:239–43. O'Reilly PH; Consensus Committee of the Society of Radionuclides in Nephrourology. Standardization of the renogram technique for investigating the dilated upper urinary tract and assessing the results of surgery. BJU Int. 2003;91:239–43.
28.
Zurück zum Zitat Ransley P, Manzoni G. Extended role of DTPA scan in assessing function and UPJ obstruction in neonate. Dial Ped Urol. 1985;8:6–8. Ransley P, Manzoni G. Extended role of DTPA scan in assessing function and UPJ obstruction in neonate. Dial Ped Urol. 1985;8:6–8.
29.
Zurück zum Zitat Conway JJ, Maizels M. The “well tempered” diuretic renogram: a standard method to examine the asymptomatic neonate with hydronephrosis or hydroureteronephrosis. A report from combined meetings of the Society for Fetal Urology and members of the pediatric nuclear medicine council, the Society of Nuclear Medicine. J Nucl Med. 1992;33:2047–51.PubMed Conway JJ, Maizels M. The “well tempered” diuretic renogram: a standard method to examine the asymptomatic neonate with hydronephrosis or hydroureteronephrosis. A report from combined meetings of the Society for Fetal Urology and members of the pediatric nuclear medicine council, the Society of Nuclear Medicine. J Nucl Med. 1992;33:2047–51.PubMed
30.
Zurück zum Zitat Gordon I, Piepsz A, Sixt R. Guidelines for standard and diuretic renogram in children. Eur J Nucl Med Mol Imaging. 2011;38:1175–88.CrossRefPubMed Gordon I, Piepsz A, Sixt R. Guidelines for standard and diuretic renogram in children. Eur J Nucl Med Mol Imaging. 2011;38:1175–88.CrossRefPubMed
31.
Zurück zum Zitat Taghavi R, Ariana K, Arab D. Diuresis renography for differentiation of upper urinary tract dilatation from obstruction: F+20 and F-15 methods. Urol J. 2007;4:36–40.PubMed Taghavi R, Ariana K, Arab D. Diuresis renography for differentiation of upper urinary tract dilatation from obstruction: F+20 and F-15 methods. Urol J. 2007;4:36–40.PubMed
32.
Zurück zum Zitat Ueno S, Suzuki Y, Murakami T, et al. Quantitative analysis of infantile ureteropelvic junction obstruction by diuretic renography. Ann Nucl Med. 2001;15:131–6.CrossRefPubMed Ueno S, Suzuki Y, Murakami T, et al. Quantitative analysis of infantile ureteropelvic junction obstruction by diuretic renography. Ann Nucl Med. 2001;15:131–6.CrossRefPubMed
33.
Zurück zum Zitat Ross SS, Kardos S, Krill A, et al. Observation of infants with SFU grades 3-4 hydronephrosis: worsening drainage with serial diuresis renography indicates surgical intervention and helps prevent loss of renal function. J Pediatr Urol. 2011;7:266–71.CrossRefPubMed Ross SS, Kardos S, Krill A, et al. Observation of infants with SFU grades 3-4 hydronephrosis: worsening drainage with serial diuresis renography indicates surgical intervention and helps prevent loss of renal function. J Pediatr Urol. 2011;7:266–71.CrossRefPubMed
34.
Zurück zum Zitat Rossleigh MA, Thomas MY, Moase AL. Determination of the normal range of furosemide half-clearance times when using Tc-99m MAG3. Clin Nucl Med. 1994;19:880–2.CrossRefPubMed Rossleigh MA, Thomas MY, Moase AL. Determination of the normal range of furosemide half-clearance times when using Tc-99m MAG3. Clin Nucl Med. 1994;19:880–2.CrossRefPubMed
35.
Zurück zum Zitat Ransley PG, Dhillon HK, Gordon I, Duffy PG, Dillon MJ, Barratt TM. The postnatal management of hydronephrosis diagnosed by prenatal ultrasound. J Urol. 1990;144:584–7.PubMed Ransley PG, Dhillon HK, Gordon I, Duffy PG, Dillon MJ, Barratt TM. The postnatal management of hydronephrosis diagnosed by prenatal ultrasound. J Urol. 1990;144:584–7.PubMed
36.
Zurück zum Zitat Hafez AT, McLorie G, Bagli D, Khoury A. Analysis of trends on serial ultrasound for high grade neonatal hydronephrosis. J Urol. 2002;168:1518–21.CrossRefPubMed Hafez AT, McLorie G, Bagli D, Khoury A. Analysis of trends on serial ultrasound for high grade neonatal hydronephrosis. J Urol. 2002;168:1518–21.CrossRefPubMed
37.
Zurück zum Zitat Piepsz A, Hall M, Ham HR, Verboven M, Collier F. Prospective management of neonates with pelviureteric junction stenosis. Therapeutic strategy based on 99m Tc-DPTA studies. Scand J Urol Nephrol. 1989;23:31–6.CrossRefPubMed Piepsz A, Hall M, Ham HR, Verboven M, Collier F. Prospective management of neonates with pelviureteric junction stenosis. Therapeutic strategy based on 99m Tc-DPTA studies. Scand J Urol Nephrol. 1989;23:31–6.CrossRefPubMed
38.
Zurück zum Zitat Duong HP, Piepsz A, Collier F, et al. Predicting the clinical outcome of antenatally detected unilateral pelviureteric junction stenosis. Urology. 2013;82:691–6.CrossRefPubMed Duong HP, Piepsz A, Collier F, et al. Predicting the clinical outcome of antenatally detected unilateral pelviureteric junction stenosis. Urology. 2013;82:691–6.CrossRefPubMed
39.
Zurück zum Zitat Karnak I, Woo LL, Shah SN, Sirajuddin A, Ross JH. Results of a practical protocol for management of prenatally detected hydronephrosis due to ureteropelvic junction obstruction. Pediatr Surg Int. 2009;25:61–7.CrossRefPubMed Karnak I, Woo LL, Shah SN, Sirajuddin A, Ross JH. Results of a practical protocol for management of prenatally detected hydronephrosis due to ureteropelvic junction obstruction. Pediatr Surg Int. 2009;25:61–7.CrossRefPubMed
40.
Zurück zum Zitat Stock JA, Krous HF, Heffernan J, Packer M, Kaplan GW. Correlation of renal biopsy and radionuclide renal scan differential function in patients with unilateral ureteropelvic junction obstruction. J Urol. 1995;154:716–8.CrossRefPubMed Stock JA, Krous HF, Heffernan J, Packer M, Kaplan GW. Correlation of renal biopsy and radionuclide renal scan differential function in patients with unilateral ureteropelvic junction obstruction. J Urol. 1995;154:716–8.CrossRefPubMed
41.
Zurück zum Zitat Chiou YY, Chiu NT, Wang ST, Cheng HL, Tang MJ. Factors associated with the outcomes of children with unilateral ureteropelvic junction obstruction. J Urol. 2004;171:397–402.CrossRefPubMed Chiou YY, Chiu NT, Wang ST, Cheng HL, Tang MJ. Factors associated with the outcomes of children with unilateral ureteropelvic junction obstruction. J Urol. 2004;171:397–402.CrossRefPubMed
42.
Zurück zum Zitat Nguyen HT, Gluckman GR, Kogan BA. Changing the technique of background subtraction alters calculated renal function on pediatric mercaptoacetyltriglycine renography. J Urol. 1997;158:1252–6.CrossRefPubMed Nguyen HT, Gluckman GR, Kogan BA. Changing the technique of background subtraction alters calculated renal function on pediatric mercaptoacetyltriglycine renography. J Urol. 1997;158:1252–6.CrossRefPubMed
43.
Zurück zum Zitat Boubaker A, Meyrat B, Frey P, Bischof DA. Unilateral urinary flow impairment at the pelviureteral junction: outcome of renal function with respect to therapeutic strategy. Urology. 2003;61:1224–8.CrossRefPubMed Boubaker A, Meyrat B, Frey P, Bischof DA. Unilateral urinary flow impairment at the pelviureteral junction: outcome of renal function with respect to therapeutic strategy. Urology. 2003;61:1224–8.CrossRefPubMed
44.
Zurück zum Zitat Chertin B, Rolle U, Farkas A, Puri P. Does delaying pyeloplasty affect renal function in children with a prenatal diagnosis of pelvi-ureteric junction obstruction? BJU Int. 2002;90:72–5.CrossRefPubMed Chertin B, Rolle U, Farkas A, Puri P. Does delaying pyeloplasty affect renal function in children with a prenatal diagnosis of pelvi-ureteric junction obstruction? BJU Int. 2002;90:72–5.CrossRefPubMed
45.
Zurück zum Zitat Palmer LS, Maizels M, Cartwright PC, Fernbach SK, Conway JJ. Surgery versus observation for managing obstructive grade 3 to 4 unilateral hydronephrosis: a report from the Society for Fetal Urology. J Urol. 1998;159:222–8.CrossRefPubMed Palmer LS, Maizels M, Cartwright PC, Fernbach SK, Conway JJ. Surgery versus observation for managing obstructive grade 3 to 4 unilateral hydronephrosis: a report from the Society for Fetal Urology. J Urol. 1998;159:222–8.CrossRefPubMed
46.
Zurück zum Zitat Wåhlin N, Magnusson A, Persson AE, Läckgren G, Stenberg A. Pressure flow measurement of hydronephrosis in children: a new approach to definition and quantification of obstruction. J Urol. 2001;166:1842–7.CrossRefPubMed Wåhlin N, Magnusson A, Persson AE, Läckgren G, Stenberg A. Pressure flow measurement of hydronephrosis in children: a new approach to definition and quantification of obstruction. J Urol. 2001;166:1842–7.CrossRefPubMed
47.
Zurück zum Zitat McMann LP, Kirsch AJ, Scherz HC, et al. Magnetic resonance urography in the evaluation of prenatally diagnosed hydronephrosis and renal dysgenesis. J Urol. 2006;176:1786–92.CrossRefPubMed McMann LP, Kirsch AJ, Scherz HC, et al. Magnetic resonance urography in the evaluation of prenatally diagnosed hydronephrosis and renal dysgenesis. J Urol. 2006;176:1786–92.CrossRefPubMed
48.
Zurück zum Zitat Kessler RM, Quevedo H, Lankau CA, et al. Obstructive vs nonobstructive dilatation of the renal collecting system in children: distinction with duplex sonography. AJR Am J Roentgenol. 1993;160:353–7. Kessler RM, Quevedo H, Lankau CA, et al. Obstructive vs nonobstructive dilatation of the renal collecting system in children: distinction with duplex sonography. AJR Am J Roentgenol. 1993;160:353–7.
49.
Zurück zum Zitat Okada T, Yoshida H, Iwai J, et al. Pulsed Doppler sonography of the hilar renal artery: differentiation of obstructive from nonobstructive hydronephrosis in children. J Pediatr Surg. 2001;36:416–20.CrossRefPubMed Okada T, Yoshida H, Iwai J, et al. Pulsed Doppler sonography of the hilar renal artery: differentiation of obstructive from nonobstructive hydronephrosis in children. J Pediatr Surg. 2001;36:416–20.CrossRefPubMed
50.
Zurück zum Zitat Bajpai M, Bal CS, Tripathi M, Kalaivani M, Gupta AK. Prenatally diagnosed unilateral hydronephrosis: prognostic significance of plasma renin activity. J Urol. 2007;178:2580–4.CrossRefPubMed Bajpai M, Bal CS, Tripathi M, Kalaivani M, Gupta AK. Prenatally diagnosed unilateral hydronephrosis: prognostic significance of plasma renin activity. J Urol. 2007;178:2580–4.CrossRefPubMed
51.
Zurück zum Zitat Decramer S, Bascands JL, Schanstra JP. Non-invasive markers of ureteropelvic junction obstruction. World J Urol. 2007;25:457–65.CrossRefPubMed Decramer S, Bascands JL, Schanstra JP. Non-invasive markers of ureteropelvic junction obstruction. World J Urol. 2007;25:457–65.CrossRefPubMed
52.
Zurück zum Zitat Gatti JM, Broecker BH, Scherz HC, Perez-Brayfield MR, Kirsch AJ. Antenatal hydronephrosis with postnatal resolution: how long are postnatal studies warranted? Urology. 2001;57:1178.CrossRef Gatti JM, Broecker BH, Scherz HC, Perez-Brayfield MR, Kirsch AJ. Antenatal hydronephrosis with postnatal resolution: how long are postnatal studies warranted? Urology. 2001;57:1178.CrossRef
53.
Zurück zum Zitat Song SH, Lee SB, Park YS, Kim KS. Is antibiotic prophylaxis necessary in infants with obstructive hydronephrosis? J Urol. 2007;177:1098–101.CrossRefPubMed Song SH, Lee SB, Park YS, Kim KS. Is antibiotic prophylaxis necessary in infants with obstructive hydronephrosis? J Urol. 2007;177:1098–101.CrossRefPubMed
54.
Zurück zum Zitat Madden NP, Thomas DF, Gordon AC, Arthur RJ, Irving HC, Smith SE. Antenatally detected pelviureteric junction obstruction. Is non-operation safe? Br J Urol. 1991;68:305–10.CrossRefPubMed Madden NP, Thomas DF, Gordon AC, Arthur RJ, Irving HC, Smith SE. Antenatally detected pelviureteric junction obstruction. Is non-operation safe? Br J Urol. 1991;68:305–10.CrossRefPubMed
Metadaten
Titel
Is it Always Necessary to Treat an Asymptomatic Hydronephrosis Due to Ureteropelvic Junction Obstruction?
verfasst von
Yogesh Kumar Sarin
Publikationsdatum
03.05.2017
Verlag
Springer India
Erschienen in
Indian Journal of Pediatrics / Ausgabe 7/2017
Print ISSN: 0019-5456
Elektronische ISSN: 0973-7693
DOI
https://doi.org/10.1007/s12098-017-2346-9

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