Long-term Outcomes of Antenatal Hydronephrosis in Relation to Adult Pyeloplasty

Background: Antenatal hydronephrosis (ANH) occurs in approximately 1% of pregnancies. While many affected infants undergo monitoring and are discharged without intervention, 30-60% will ultimately receive a pathological diagnosis. Moreover, around 50% of severe cases may require surgical intervention, such as pyeloplasty, during childhood. Rationale: Despite the prevalence of ANH, there is a significant gap in the literature regarding the long-term outcomes for individuals diagnosed with ANH and their subsequent need for surgical treatment in adulthood. This study will focus on a specific sample frame: adults who have undergone pyeloplasty. By investigating this population, we aim to assess the prevalence of ANH in childhood among those requiring surgical intervention and the extent and results of the investigations they received during childhood. Objectives: This study will systematically review adults who have had pyeloplasty over several decades. We will explore the following key questions: What percentage of these adults had a diagnosis of antenatal hydronephrosis during childhood? To what extent were their conditions investigated during childhood? What details of their investigations and clinical presentations can inform our understanding of the relationship between childhood ANH and adult surgical requirements? Hypothesis Generation: The primary goal of this research is to generate hypotheses regarding potential predictive factors associated with the necessity for pyeloplasty during childhood. Specifically, we will investigate whether certain indicators observed during childhood can serve as reliable predictors for the surgical intervention in adulthood.