Conditions + Treatments

Hydronephrosis | Treatments

LIke ThisLIke ThisLIke ThisLIke ThisLIke This

Contact the Department of Urology

  • 1-617-355-7796

What are the treatment options for hydronephrosis?

After considering the nature and cause of the hydronephrosis, doctors will decide between recommending observation or surgery.

Fetal intervention

In very rare instances, prenatal hydronephrosis is so severe that it puts the fetus at risk. This usually means the obstruction is in the child's urethra, blocking drainage of the bladder and both kidneys. In turn, this results in a dangerously low amount of amniotic fluid (a condition called oligohydramnios).

Observation

If postnatal testing shows your child has mild to moderate hydronephrosis, your doctor may recommend allowing time for the condition to correct itself on its own. Your child may receive a low dose of antibiotics to prevent infection. Repeat ultrasounds will let us check for improvement.

Observation has become the accepted method of treatment in children with mild hydronephrosis. Even in children with moderate hydronephrosis, if kidney function is not lost and kidneys are growing well, observation can allow the condition to correct itself.

Surgery

Only in severe cases would surgery be needed. The goal of the operation is to reduce the swelling and pressure in the kidney by restoring the free flow of urine.

The most common surgical procedure is pyeloplasty. This repairs the most common type of blockage that causes hydronephrosis: ureteropelvic junction obstruction (UPJ). In pyeloplasty, the surgeon will remove the narrowed or obstructed part of the ureter. Then, the healthy portion is reconnected to the kidney's drainage system. After open surgery (small incision over the kidney), children usually stay in the hospital for about two to three days. They heal in two to three weeks. The success rate is about 95 percent. 

Other surgical treatments may be recommended for your child, depending on what's causing the hydronephrosis and how severe it is. To learn more about these, see: ureteropelvic junction obstruction, vesicoureteral reflux, posterior urethral valves and ureteroceles.

Robot-assisted and minimally-invasive surgery

This innovative tool is used for about half of the pyeloplasties performed by our urological team.

A robot-assisted pyeloplasty is a minimally invasive laparoscopic procedure. With the use of a tiny camera, surgeons operate using very thin instruments inserted into three or four small incisions. Robot-assisted pyeloplasty removes an obstructed section of the ureter and reattaches the healthy portion to the kidney's drainage system.

Robotic surgery can offer a number of benefits as compared to traditional (open) surgery, including:

  • less discomfort after the operation
  • smaller scars on the belly
  • a shorter hospital stay—usually 24 to 48 hours
  • quicker recovery
  • earlier return to full activities

Even if pyeloplasty is recommended for your child, a robot-assisted procedure may or may not be suitable. Your doctor will recommend the best options for your child.  

Hydrophrenosis

Boston Children’s is so much more than a hospital—it’s a community of researchers, clinicians, administrators, support staff, innovators, teachers, patients and families, all working together to make the impossible possible. ”
- Sandra L. Fenwick, President and CEO

Boston Children's Hospital
300 Longwood Avenue, Boston, MA 02115
For Patients: 617-355-6000
For Referring Providers: 844-BCH-PEDS | 844-224-7337

Close