F. Hofmeister et al., Differences in diagnostic strategies in asymptomatic unilateral congenitalhydronephrosis, WIEN KLIN W, 113(13-14), 2001, pp. 510-515
Background: Routine sonographic screening results in an increasing number o
f neonates diagnosed with asymptomatic congenital hydronephrosis. Clinical
relevance of this finding is difficult to assess, as congenital hydronephro
sis can be a symptom of various severe pathologies of the urinary tract, bu
t also a normal variant. There is no general consensus regarding the diagno
stic procedures in these neonates.
Method: In order to investigate different diagnostic strategies for asympto
matic unilateral congenital hydronephrosis, a questionnaire was designed an
d 75% of the pediatric departments in four federal states in eastern Austri
a were interviewed.
Results: Whereas there were clear diagnostic strategies for severe hydronep
hrosis, less extreme but more frequent findings resulted in markedly diverg
ent indications and timing of diagnostic procedures. This was particularly
evident with regard to classification of ultrasound findings, indication fo
r voiding-cystourethrogram and initiation of antibiotic prophylaxis. A chil
d which would be observed clinically for months in one center might be imme
diately operated on in another.
Conclusion: In all interviews, the need of a general consensus on diagnosti
c strategies for asymptomatic unilateral congenital hydronephrosis became a
pparent.