The management of infants with hydronephrosis diagnosed in utero

The management of asymptomatic hydronephrosis detected antenatally in the young infant is an area of great controversy in pediatric urology. The conclusive diagnosis of obstruction in a patient with an apparent ureteropelvic junction anomaly remains difficult. Many physicians support early pyeloplasty; however, more recent data suggest that this may not be necessary in all cases. The natural history of hydronephrosis will best be delineated through an outcome analysis trial of early pyeloplasty compared with observation.