A 5 French feeding tube was inserted to drain the bladder. A repeat ultrasound showed stable hydronephrosis on the right, increase hydronephrosis on the left, and a decompressed bladder. Due to the persistently elevated creatinine and the increased risk of infections with prolonged intubated urinary drainage, the patient was taken to the operating suite for a left cutaneous pyelostomy and left renal biopsy. The biopsy showed immature kidney with no specific diagnostic histopathologic changes. Discussion Prenatal ultrasonography permits in utero diagnosis of hydronephrosis prior to clinical evidence of an obstructive uropathy during the postnatal period.
Sonography is repeated postnatally to confirm the presence of hydronephrosis.
4 Reflux in association with posterior urethral valves implies a worse prognosis for the involved kidney. This reflux will usually resolve following valve ablation. However, the high grades of reflux which our patient had tend to be associated with nonfunctioning, dysplastic kidneys. We did not obtain a pathologic diagnosis of renal dysplasia of the right kidney which had the high grade reflux. However, the radiologic studies are consistent with a dysplastic right kidney.