Herndon C D Anthony
University of Alabama at Birmingham, AL, USA.
ScientificWorldJournal. 2006 Mar 5;6:2345-65. doi: 10.1100/tsw.2006.366.
The diagnosis, evaluation and management of antenatal hydronephrosis has undergone a two stage paradigm shift since the advent of prenatal ultrasonography in the early 1980s. Initially the identification of a large number of asymptomatic infants appeared to afford the surgeon the opportunity for preemptive intervention. However, it has now become apparent that antenatal hydronephrosis (AH) is far more difficult to interpret than originally perceived. The initial enthusiasm for surgery has now been replaced by a much more conservative approach to ureteropelvic junction(UPJ) obstruction, multi-cystic dysplastic kidney(MCDK), vesicoureteral reflux and the non-refluxing megaureter. This review will highlight the postnatal evaluation of AH and include an overview of the Society for Fetal Urology grading system for hydronephrosis. The differential diagnosis and treatment options for UPJ obstruction, vesicoureteral reflux, MCDK, duplication anomalies, megaureter, and posterior urethral valves will be discussed.
自20世纪80年代初产前超声检查问世以来，产前肾积水的诊断、评估和管理经历了两个阶段的范式转变。最初，大量无症状婴儿的发现似乎为外科医生提供了抢先干预的机会。然而，现在已经很明显，产前肾积水（AH）比最初认为的要难解释得多。最初对手术的热情现在已被对肾盂输尿管连接处（UPJ）梗阻、多囊性发育不良肾（MCDK）、膀胱输尿管反流和无反流巨输尿管采取的更为保守的方法所取代。本综述将重点介绍AH的产后评估，并概述胎儿泌尿外科学会肾积水分级系统。还将讨论UPJ梗阻、膀胱输尿管反流、MCDK、重复畸形、巨输尿管和后尿道瓣膜的鉴别诊断和治疗选择。
