At Boston Children's Hospital, we provide compassionate and unsurpassed urological care to children with hydronephrosis. Ranked #1 in urology by U.S. News & World Report 2014-15, our physicians, nurses and radiologists are expertly trained in pediatric urology an have extensive experience with this condition. At Boston Children’s, we will make sure you and your family have all the information needed to manage your child's hydronephrosis.

If your child is diagnosed with hydronephrosis and a cause has already been identified, we can provide a second opinion with the goal of returning your child to good health as soon as possible. Click here to learn more or call 888-545-1433 to make an appointment with a hydronephrosis specialist today.


What is postnatal hydronephrosis?

Postnatal hydronephrosis is a condition diagnosed after birth, where urine backs up into the kidney causing the kidney to swell. Hydronephrosis is typically caused by either something blocking urine flow or by urine leaking backward through the urinary system (reflux).

What are the signs and symptoms of postnatal hydronephrosis?

If your infant has had multiple urinary tract infections (UTIs) with (or without) a fever, it could indicate some kind of obstruction or reflux in the urinary system.  UTIs can be difficult to spot in infants. In many cases, multiple, unexplained fevers are the only sign.

Older children may have more recognizable symptoms of UTIs, including a strong urge to urinate, painful urination or cloudy urine. If your child tends to get repeat UTIs, you may want to have him evaluated by a pediatric urologist for possible urinary tract obstruction.

How is postnatal hydronephrosis detected?

For newborns and older children, doctors may use some or all of the following tests to help determine the cause and nature of the hydronephrosis. Talk with your urology specialist to determine which tests, if any, are appropriate.

  • • Renal ultrasound (RUS)By focusing on the kidneys, this ultrasound gives a good picture of the hydronephrosis. This is the first postnatal test your doctor will perform and will help determine whether further studies are needed.
  • • Voiding cystourethrogram (VCUG)This special kind of x-ray is used to check for reflux, a common cause of hydronephrosis. It also may show an obstruction in the urethra.
  • • Renal scan (MAG 3)This test allows doctors to see your child’s kidneys and learn more about how they are functioning. This kidney-scanning test helps measure the difference in function between the two kidneys and also estimates the degree of blockage in the urinary system.

After we complete all necessary tests, our experts meet to review and discuss what they have learned about your child's condition. Then we will meet with you and your family to discuss the results and outline the best treatment options.

Treatment options

Types of postnatal hydronephrosis: Mild, Moderate and Severe

Your child’s doctor will describe your child’s hydronephrosis as mild, moderate or severe and whether it affects one kidney (unilateral) or both kidneys (bilateral). A mild, moderate or severe description is based on how much the kidney is stretched and how much the urinary flow is impaired. A severe description is an indication that the kidney function has likely been affected.

Mild: Kidney function is slightly affected. In many cases, the condition resolves itself.
Moderate: Kidney function is moderately affected. The condition will be closely monitored.
Severe: Kidney function is likely affected.

Hydronephrosis treatment at Boston Children's Hospital

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Treatment options:

In children who have mild or, sometimes, moderate hydronephrosis, kidney function is frequently unharmed. In these cases, doctors may recommend prescribing a low dose of antibiotics to prevent infection.

For children with moderate hydronephrosis, surgery is recommended about 25 percent of the time. For those with severe hydronephrosis, surgery is advised about 75 percent of the time. If surgery is required, our urology experts will provide the most minimally invasive options. Our success rate is 95 percent and unsurpassed.

Boston Children's Difference

Ranked #1 in by U.S. News & World Report 2014-15, the Department of Urology at Boston Children’s Hospital is a recognized leader in the evaluation, diagnosis and treatment of infants, children and adolescents with disorders of the genitals, urinary tract, bladder, and kidneys. 

Our department is staffed by expert physicians who are teachers, leaders and innovators dedicated to providing state of the art urologic care, surgical expertise and research in all aspects of pediatric urology.

If your child is diagnosed with a urological disorder, whether it's a relatively common condition or a rare, complex congenital condition, we can help you.

Boston Children’s Hospital: A Research & Innovation Leader

Although best known for the best-in-class care we deliver, Boston Children’s is so much more than a great pediatric hospital. Home to the world’s largest and most active research enterprise at a pediatric hospital, we strive tirelessly to revolutionize medicine, science and care delivery, to create a brighter future for all families, everywhere.

Our culture of innovation crosses all levels of our hospital, starting with the researchers, scientists and clinicians who have made it their life’s work to discover and develop new breakthroughs in care. From tiny tools designed to perform minimally invasive surgery, to longer lasting anesthetics for post-operative pain control, we are never satisfied until we’ve made the impossible possible.