Pediatric Hydronephrosis

MU Health Care provides expert, team-based care for children with hydronephrosis, from diagnosis through recovery.

Hydronephrosis is a condition where one or both of your child’s kidneys become swollen from a buildup of urine. This is often caused by a blockage in the urinary tract or urine flowing backwards from the bladder into the kidneys. This condition may be diagnosed during pregnancy or after birth if symptoms or imaging indicate kidney swelling due to a blockage.

At MU Health Care, our pediatric urology team works with radiologists and nephrologists to understand your child’s condition and determine the best path forward. Whether your child needs close monitoring or surgery, we provide clear guidance and support at every step.

Pediatric Hydronephrosis Symptoms

Symptoms can vary depending on your child’s age and the severity of the condition. In many cases, there are no noticeable signs of kidney swelling, especially if the condition is caught during prenatal imaging.

Possible symptoms of hydronephrosis in your child include:

A urinary tract infection (UTI)
Fever or vomiting with no obvious cause
Pain in the abdomen or side
Swelling in the belly
Blood in the urine

Some children experience sudden pain in their side or belly that comes and goes, sometimes with vomiting. These symptoms may point to a kidney issue and should be evaluated by a doctor.

When to Seek Care

If your child has recurrent UTIs, unexplained abdominal pain or hydronephrosis was found on a prenatal ultrasound, talk to your pediatrician or a pediatric urologist. Early evaluation can help avoid long-term kidney damage.

Types of Pediatric Hydronephrosis

Hydronephrosis may be classified by cause or severity:

Prenatal (antenatal) hydronephrosis: Found during routine ultrasounds in pregnancy
Obstructive hydronephrosis: Caused by a blockage in the urinary tract
Reflux hydronephrosis: Caused by urine flowing backwards from the bladder to the kidney (vesicoureteral reflux)
Nonobstructive, mild hydronephrosis: Sometimes resolves on its own with regular monitoring

Our team will help you understand which type of hydronephrosis your child has and provide personalized options for their care.

Pediatric Hydronephrosis Diagnosis at MU Health Care

Diagnosis typically begins with a kidney and bladder ultrasound. If hydronephrosis is suspected or confirmed, your child may also undergo the following tests:

Voiding cystourethrogram (VCUG) to check for urine reflux
Renal scan to assess how well the kidneys are working
Blood and urine tests to check for infection and kidney function

Pediatric urologists and nephrologists work side-by-side in the same clinic, making diagnostic efforts more efficient and coordinated — so your child gets complete care in fewer appointments.

Pediatric Hydronephrosis Treatment at MU Health Care

Treatment depends on the severity of the hydronephrosis and its underlying cause.

Nonsurgical Treatment for Kidney Swelling

Surgery is not always needed for hydronephrosis. Our team will carefully monitor your child’s condition with the following:

Observation and imaging to watch for improvement or worsening
Antibiotics to prevent UTIs in babies or children with a higher risk
Dietary guidance from pediatric nutrition specialists, if needed

Otherwise, your care team will only recommend surgery when it becomes necessary. Together, we weigh symptoms, imaging results and the best timing for your child’s development.

Surgical Treatment for Hydronephrosis

Surgery may be needed if your child’s swelling is severe, getting worse, or linked to repeated infections or poor kidney function or drainage.

Our pediatric urologists offer surgical options when appropriate, such as:

Pyeloplasty: The most common procedure to remove a blockage at the ureteropelvic junction.
Ureteral reimplantation: Corrects abnormal placement of ureter or reflux from the bladder.
Stent or catheter placement: Helps drain urine while healing.

Children typically stay in the hospital for one night and can return home the next day. Your care team will make sure your family is well supported for at-home recovery.

What to Expect After Surgery

After surgery for hydronephrosis, your child may need:

Temporary use of a stent or catheter
Oral antibiotics to prevent infection
Pain management (your care team will provide clear instructions)

You’ll return for a follow-up visit in a few weeks to monitor your child’s healing. Your child’s doctor may recommend periodic imaging over time to confirm good kidney function. In many cases, no further treatment is needed after recovery.