PUJ obst/ PUV (suspected)

Hello dear fellow doctors. Me- Dr Kishor Kumar is forwarding the follow up USG report after 4 days of birth of my maternal grandson. He is passing urine stool normally. Taking feeds. No visible complaints. Please opine anout further course of action and prognosis. Thanks Dr Kishor Kumar

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Hi sir, congratulations. Unfortunately there is no comment on Ureteric dilatation, bladder wall thickness etc on this ultrasound. We will need that assessment. I can understand that keeping full bladder is difficult in neonates, but maybe repeating an hour after feeding can help. Meanwhile, boy or a girl? Boys have higher chances of PUV. Also, have you noticed urine stream? Is it normal or just a dribble? Normal jetlike stream is good. The measurements suggest moderate bilateral Neonatal hydronephrosis. If next ultrasound suggest normal bladder and ureters... i would advice to continue Antibiotic prophylaxis till you get Micturating cystourethrogram by 4-5 weeks of age while monitoring for signs of UTI. If ultrasound shows thick bladder wall, ureter dilatation etc.. then MCU as soon as possible to rule out PUV. Continue antibiotic prophylaxis. Signs of UTI in neonates- poor feeding, fever, drowsiness, breathing difficulties etc.

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Thanks brother. No signs of UTI. Male baby Has been adviced a review USG a week later. Will watch the trajectory of micturition. Thanks again.