2001 Volume 92 Issue 6 Pages 615-618
(AIMS) To review our experience of neonates with unilateral multicystic dysplastic kidneys (MCDKs) and to plan how to manage this anomaly.
(PATIENTS and METHODS) Forty-eight neonates (30boys, 18girls) with unilateral MCDK were referred to our institute between August 1991 and Februaly 1999. Urological evaluation was performed by USG, VCUG and radionuclide study. Follow-up period was 15 month to 106 months (Ave. 54months).
(RESULTS) Forty-five of 48 (93.8%) MCDKs were found prenatally. No surgical procedure was performed in utero. Seven (14.6%) had low grade vesicoureteral reflux (ipsilateral 5, contralateral 2). Dilation of contralateral upper urinaly tract was detected in 16 (33.3%) neonates and diuretic renography revealed 4PUJ obstruction and 2mid-ureteral stenosis. Althouth 29 of 48 (60.4%) MCDKs were large, no neonate showed mass effect which caused vomiting or dyspnea. All MCDKs except two, which removed because of ipsilateral ureterocele or ectopic ureter, were followed conservatively. Two boys had nephrectomy when they became 5-year-old on their parent's request. Surgical correction of contralateral urinary tract anomaly, 3 pyeloplasty and 2 end-to-end ureteral anastomosis, was performed. All neonates but one with contralareral hypodysplastic kidney had good renal function. Neither hypertension nor malignant tumor had occurred.
(CONCLUSION) These findings suggest that neonates with unilateral MCDKs can be treated conservertively only if they have no contralateral serious anomaly. Surgical intervention is not nessesery for unilateral MCDKs before and after birth but socially and/or economically it depends on patients' request.