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Review
. 2024 Dec 23;11(12):1561.
doi: 10.3390/children11121561.

Swiss Consensus on Prenatal and Early Postnatal Urinary Tract Dilation: Practical Approach and When to Refer

Atessa Bahadori  1   2 , Alexandra Wilhelm-Bals  1 , Julien Caccia  3 , Hassib Chehade  4 , Alexandra Goischke  5 , Céline Habre  6 , Daniela Marx-Berger  7 , Samuel Nef  8 , Oliver Sanchez  9 , Giuseppina Spartà  10 , Isabelle Vidal  11 , Rodo O von Vigier  12 , Jacques Birraux  11 , Paloma Parvex  1
Affiliations
Review

Swiss Consensus on Prenatal and Early Postnatal Urinary Tract Dilation: Practical Approach and When to Refer

Atessa Bahadori et al. Children (Basel). .

Abstract

Urinary tract dilations (UTDs) are the most frequent prenatal renal anomaly. The spectrum of etiologies causing UTD ranges from mild spontaneously resolving obstruction to severe upper and lower urinary tract obstruction or reflux. The early recognition and management of these anomalies allows for improved renal endowment prenatally and ultimately better outcome for the child. The role of the general obstetrician and pediatrician is to recognize potential prenatal and postnatal cases addressed to their practice and to refer patients to specialized pediatric nephrology and urology centers with a sense of the urgency of such a referral. The aim of this paper is to offer clinical recommendations to clinicians regarding the management of neonates and children born with prenatally detected UTD, based on a consensus between Swiss pediatric nephrology centers. The aim is to give suggestions and recommendations based on the currently available literature regarding classifications and definitions of prenatal and postnatal UTD, etiologies, prenatal and postnatal renal function evaluation, investigations, antibiotic prophylaxis, and the need for referral to a pediatric nephrologist and/or urologist. The overarching goal of a systematic approach to UTD is to ultimately optimize kidney health during childhood and improve long-term renal function prognosis.

Keywords: VCUG; megaureter; posterior urethral valves; postnatal urinary tract dilatation; prenatal diagnosis; ultrasound; ureteropelvic junction obstruction; urinary tract dilation; vesicoureteric reflux.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Figure 1
Figure 1
Types of congenital anomalies of the kidneys and urinary tract (CAKUTs) in a 10-year cohort studied in Geneva, Switzerland. Unilateral and bilateral pelvic dilation represent 61% of CAKUTs. UTD: urinary tract dilation; PUV: posterior urethral valves; MCKD: multicystic dysplastic kidney.
Figure 2
Figure 2
(A) Proposed postnatal follow-up for prenatal urinary tract dilation; (B) definitions.
Figure 2
Figure 2
(A) Proposed postnatal follow-up for prenatal urinary tract dilation; (B) definitions.
See this image and copyright information in PMC

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