—Hinman1 discusses the various problems and types of surgical treatment in hydronephrosis. He states that the only cure is removal of the obstruction causing the condition and that, therefore, the first step in treatment is to determine the cause, degree, complexity and site of the obstruction. The condition of the renal parenchyma must be determined as, in addition to hydronephrotic atrophy, acute, chronic or atrophic pyelonephritis may be present which would cause progressive loss of renal function even after removal of the obstruction. The aim in treatment is preservation of renal tissue with the least risk.In ureteropelvic obstruction, if an uninfected hydronephrotic kidney is capable of performing a fifth to a fourth of total function and reserve potentialities exist there is good reason to attempt plastic repair; otherwise, nephrectomy is indicated. If hydronephrosis is bilateral nephrectomy should be performed only when a kidney is functionless. If
SCHOLL AJ, HINMAN F, HEPLER AB, et al. REVIEW OF UROLOGIC SURGERY. Arch Surg. 1947;54(6):701–732. doi:10.1001/archsurg.1947.01230070712009
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