In response to a question : how to treat silent hydronefrosis (without pain) and a marked reduction in kidney function ?

AAGL-ENDO-EXCHANGE Digest - 7 Aug 2011 to 8 Aug 2011

Date:    Mon, 8 Aug 2011 15:50:26 -0400
From:    Philippe Koninckx and Anastasia Ussia <Gary_Frishman@BROWN.EDU>
Subject: Chronic hydronephrosis surgical management

In all cases seen with hydronephrosis until today (around 100): strategy has
been consistently the same
* insert a stent if possible

* dissect the ureter what will give the diagnosis of the cause of the
hydronephrosis ie generally endometriosis, rarely compression only. Anyway
this becomes apparent during dissection.

* during dissection decide whether excision of surrounding endometriosis is
sufficient or whether a resection anastomosis is necessary (a reimplantation
almost always is a secondary option after failure as published)

Since dissection of the ureter was not done, I would suggest repeat surgery.

The prognosis of the kidney function is difficult to predict since the duration
that the hydronephrosis existed is unknown.

Sincerely

Philippe Koninckx and Anastasia Ussia
Gruppo Italo Belga, Belgium and Italy