Obstructive Uropathy in Newborns.

One percent babies are born with varying grades of obstructive uropathy. In less than half of them surgical intervention may be necessary at the right time to protect the kidney from deterioration. Bilateral obstruction is commonly due to infravesical obstruction secondary to lesions at bladder outlet or urethra i.e., posterior urethral valves in boys and uretrocoele in girls. Majority of them are symptomatic and may require intervention in the neonatal age. The corner stone of diagnosis is a well performed micturating cystourethrogram. Endoscopic procedure under direct vision and videorecording can take care of the vast majority of the lower urinary tract lesions in newborns. The commonest aetology of upper urinary tract obstruction are pelviuretric junction obstruction and vesicoureteric junction obstruction. A pelvic diameter of more than 15 mm and ureteric diameter more than 10 mm are significant dilatation and requires serious attention. The low GFR of a newborn kidney does not allow the functional imaging to be very reliable. Accurate and serial measurement of the pelvic dilatation along with drainage studies with isotope renogram can allow an reliable assessment by one month. In a small percentage, intervention may be necessary as early as the first month. [Copyright &y& Elsevier]