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Neonatal Hydronephrosis

Medically reviewed by Last updated on Oct 3, 2022.

What is neonatal hydronephrosis?

Neonatal hydronephrosis is a condition that prevents your newborn's urine from draining properly into his bladder. Extra urine collects and overfills the kidneys. This stretches and enlarges the kidneys, causing pain, bleeding, or infection.

What causes neonatal hydronephrosis?

  • Blocked urine flow, such as from a narrow ureter or a stone
  • Reflux (urine travels back up to the kidney)
  • Cysts in the kidneys
  • Abnormal structure, such as a ureter draining outside the bladder or 2 ureters from 1 kidney

What are the signs and symptoms of neonatal hydronephrosis?

  • Abdominal pain and swelling
  • Abdominal mass
  • Trouble urinating
  • Urine that is cloudy, pink, or red
  • Urine leaking from the belly button

How is neonatal hydronephrosis diagnosed?

Your newborn may be given a dye before some of the following tests to help healthcare providers see the organs better. Tell the healthcare provider if your newborn or a family member has ever had an allergic reaction to contrast dye.

  • Blood and urine tests will be used to check kidney function.
  • An ultrasound uses sound waves to show pictures of your newborn's kidneys and bladder on a monitor. An ultrasound may show urine buildup and if the kidneys are swollen or enlarged. It will also show blocked urine flow, cysts, or abnormal structure.
  • A voiding cystourethrogram , or VCUG, is an x-ray that will show urinary reflux and if it is severe. The pictures will show how well your newborn's bladder empties and if there is any blockage.
  • A kidney scan is a type of CT scan that will show how well your newborn's kidneys are working. This test may also show the cause of any blockage and if it is severe.

How is neonatal hydronephrosis treated?

The goal of treatment is to restore normal urine flow, relieve symptoms, and prevent infection. Your newborn may need any of the following:

  • Antibiotics help prevent an infection caused by bacteria if your newborn has urine reflux.
  • A Foley catheter may be guided through your newborn's urethra into his bladder to help drain urine.
  • Surgery may be needed to remove blockage or cysts so urine can drain normally. Abnormal structure may be fixed or a shunt may be placed to help widen a narrowed part of the urethra.

When should I contact my newborn's healthcare provider?

  • Your newborn has a fever.
  • Your newborn is fussy and cries more than usual.
  • Your newborn's urine is pink or red.
  • You have questions or concerns about your newborn's condition or care.

When should I seek immediate care or call 911?

  • Your newborn has a seizure.
  • Your newborn will not breastfeed or drink formula.
  • Your newborn is urinating less or not at all.
  • Your newborn seems weak or sleeps more than usual.

Care Agreement

You have the right to help plan your baby's care. Learn about your baby's health condition and how it may be treated. Discuss treatment options with your baby's healthcare providers to decide what care you want for your baby. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.