الفهرس 
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Abstract
Hydronephrosis refers to the accumulation of fluid (urine) in the drainage system of the kidney (the calyces and renal pelvis). It may be due to obstruction of the normal flow of urine or backflow of urine from the bladder, a condition termed reflux.
Congenital hydronephrosis giving an overall prevalence of 11.5 cases per 10,000 births, the large majority of cases were livebirths 96% of
total.
The effects of hydronephrosis on the kidney are variable. In many cases mild and sometimes even moderate degrees of hydronephrosis may cause no detectable alteration in kidney function. More severe cases may have caused or may lead to some degree of kidney dysfunction. In some cases the kidney may have been or could be destroyed by the severity of the condition.
Congenital hydronephrosis may cause no symptoms, even when it is severe. If the condition leads to urinary infection the child may have
fever and pain related to the infection.
The common causes of congenital hydronephrosis are: Pelviuretric junction obstruction (PUJ), Vesicoureteral reflux (VUR), Posterior
urethral valves (PUV), Ureterovesical junction (UVJ) obstruction,Primary nonrefluxing megaureter, Ureterocele, , Ectopic ureter, kulticystic dysplastic kidney, Autosomal recessive polycystic kidney disease, Prune belly syndrome
Congenital hydronephrosis now days usually detected antenatally, fetal intervention is an option to some case in special situation. The
diagnosis of fetal hydronephrosis is based on the recognition that renal pelvic diameter may vary with gestational age.
The urinary tract can be imaged with a number of different imaging studies which provide a detailed picture of anatomy and function.
Children suspected of having hydronephrosis are often by evaluated with several of these studies
Renal Ultrasound (RUS) this is usually the first examination. It is readily available, non-invasive and gives a good picture of the size and
shape of the kidney, CT scan it gives a precise and detailed picture of the anatomy of the urinary tract. It can be done with and without an
intravenously administered contrast agents that are filtered and excreted by the kidney, Nuclear Renal Scintigraphy (DTPA, MAG scan) can be used to evaluate how well, and how rapidly, the kidney filters and excretes waste products. This helps quantify both the degree of obstruction and the effects of obstruction on kidney function,
Voiding Cysto-uretrogram (VCUG) and magnetic resonance urogram (MRU).
Treatment of hydronephrosis depends on a variety of factors including the cause and severity, symptoms and the effects of the obstruction on
kidney function. Generally efforts to correct the condition would be considered if there are significant symptoms of pain, recurrent urinary
tract infection or impairment of kidney function. Some mild cases may cause none of these problems and some cases improve or correct
themselves as the child grows.
When symptoms or impaired function indicate a need to correct the blockage and improve the flow of urine the procedure usually involves
the surgical excision of the obstruction and re-connection of the unobstructed drainage tube above and below the blockage. Since most
obstructions are short discreet sections of the drainage system this is usually possible.