Hydronephrosis

In addition to leading the way in the use of robotic surgery, Children’s Hospital Boston is continually working toward faster, more accurate diagnoses and more effective treatments for children with urologic disorders. Among the recent areas of research that our urology department has conducted, several hold great promise for improving the lives of children with hydronephrosis.     

Finding the genetic markers of vesicoureteral reflux (VUR): One of the more common causes of hydronephrosis, VUR has long been difficult for physicians to manage and often frustrating for parents because there is currently no way to detect which children are at risk for the persistent—and often damaging—form of this condition.

Moreover, to diagnose VUR, physicians must pass a catheter up the urinary tract into the bladder. But Children’s researchers aim to replace that procedure with a simple genetic test, as well as possibly offer a way to predict which patients have VUR that will not resolve on its own.

Using proteins to target kidney obstruction: A team led by Dr. Richard Lee is studying proteins in the urine in a quest to identify illnesses at an earlier age. Specifically, the team hopes to be able to predict risk for VUR—a common cause of hydronephrosis—and detect changes in the bladder tissue that may tell them whether a child’s hydronephrosis is getting worse.

Making advances in fluorescent imaging: Recent developments in fluorescent (molecular) imaging have given physicians a potentially more accurate alternative to ultrasound and x-rays when looking at the urinary tract. Research by Hiep Nguyen, MD, shows that by using fluorescent imaging to see a child’s live urinary flow, physicians may be able to work faster and more accurately in diagnosing ureterovesical junction obstruction (UVJ), a common cause of hydronephrosis. Moreover, it may help surgeons better visualize the obstruction when operating on a child with UVJ.