In simple words: Congenital hydronephrosis is a birth defect affecting one or both kidneys.The tubes that carry urine from the kidneys become swollen and enlarged because urine can't flow properly. This can be minor or cause kidney problems depending on severity.

Congenital hydronephrosis refers to dilation of the renal pelvis and calyces of the kidney(s) present at birth.This dilation is caused by an obstruction of the normal flow of urine from the kidney. The obstruction can occur at various points along the urinary tract, such as the ureteropelvic junction (where the ureter joins the renal pelvis), the ureter itself, or the ureterovesical junction (where the ureter enters the bladder).The severity of hydronephrosis varies, ranging from mild dilation with no apparent functional impairment to severe dilation with significant renal damage and impaired kidney function.Diagnosis is often made prenatally via ultrasound or after birth, sometimes incidentally. Treatment depends on severity and may involve surgery to correct the obstruction or observation if the condition is mild and not causing symptoms.

Example 1: A pregnant woman undergoes a routine ultrasound at 20 weeks gestation and is found to have a fetus with bilateral hydronephrosis.The condition is monitored closely throughout the pregnancy, and after birth, the infant undergoes further imaging and evaluation to determine the cause and severity of the hydronephrosis. , A newborn infant presents with failure to thrive and is found to have severe unilateral hydronephrosis.Surgical intervention is performed to relieve the obstruction, followed by post-operative monitoring of kidney function., A 3-year-old child is incidentally diagnosed with mild unilateral hydronephrosis during a routine abdominal ultrasound performed for unrelated reasons.Given the mild nature of the hydronephrosis and the absence of symptoms, the child is monitored clinically without intervention.

Prenatal ultrasounds (if applicable), postnatal renal ultrasounds, voiding cystourethrograms (VCUG), renal scans (e.g., DMSA, MAG3), and other relevant imaging studies. Detailed clinical notes documenting the patient’s symptoms, physical examination findings, and laboratory results. Surgical reports (if applicable). Progress notes demonstrating ongoing monitoring and assessment of renal function.

** The severity of hydronephrosis can range from mild to severe.Treatment decisions are based on the severity of the condition, the presence of symptoms, and the age of the patient.