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Article
January 4, 1913

THE DIAGNOSIS AND INDICATIONS FOR OPERATION IN EARLY HYDRONEPHROSIS

JAMA. 1913;60(1):16-20. doi:10.1001/jama.1913.04340010018008
Abstract

The classical conception of hydronephrosis with a much-dilated pelvis, dilated calices and thinned cortex is not the view of the subject to which I desire to call attention. From the surgical point of view, comparatively little interest attaches to these extreme cases in which the surgeon steps in only in time to relieve the patient of his symptoms and at the same time of his kidney. This is the destructive aspect of surgery and it is the business of modern surgery to deal largely with the constructive side. We should regard hydronephrosis as existing in a given case when any dilatation of the renal pelvis due to obstruction has occurred. Were hydronephrosis always appreciated at its inception, nephrectomy for this condition would become a surgical curiosity. Progress in the diagnosis of lesions of the upper urinary tract has of late years been so rapid, and we have now advanced to

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