Congenital bilateral hydronephrosis diagnosed before birth, associated with vesicoureteral reflux, highlighted by urinary tract infection at the he age of 2 months - case presentation

Vesicoureteral reflux is characterized by the retrograde flow of urine from the bladder to the kidneys. Vesicoureteral reflux may be associated with urinary tract infection, hydronephrosis, and abnormal kidney development (renal dysplasia). Hydronephrosis - literally “water inside the kidney” - refers to distension and dilatation of the renal pelvis and calyces, usually caused by obstruction of the free flow of urine from the kidney. Untreated, it leads to progressive atrophy of the kidney. In cases of hydroureteronephrosis, there is distention of both the ureter and the renal pelvis and ureteres.

However, in the current era, hydronephrosis that is evident on fetal ultrasonography often heralds a ureteral abnormality. Hydronephrosis is defined as dilatation of the renal pelvis and/or calyces. Vesicoureteral reflux may present before birth as prenatal hydronephrosis, an abnormal widening of the ureter or with a urinary tract infection or acute pyelonephritis.

The authors present a case of bilateral VUR of IVth grade associated with congenital hydronephrosis of IIIrd grade, diagnosed before birth with bilateral hydronephrosis, and taken into evidence at 2 months when he was first diagnosed with urinary tract infection. Positive diagnosis was facilitated by laboratory investigations (urine analysis, urine culture, voiding cystourethrography, static renal scintigraphy).