Hydronephrosis … what does it mean? To an 11 yo boy it meant three operations within one month … but two functioning kidneys and a happy family as a result of the surgery. And, notably he presented with no symptoms except for a painless abdominal lump the size of a rock melon. The 11 yo boy, without surgery, would have ended up in renal failure.

Hydronephrosis is urine seen on ultrasound in the system that collects urine (calyces and renal pelvis) from the kidney, then directs the urine to the bladder, via the ureter (the tube between the kidney and bladder) – The black holes in the image are the urine accumulated in the kidney because of the obstruction.

Hydronephrosis is poorly managed at present because there is a lack of attention to detail in the evaluation of each VERY individual patients … patients who require little care often get over-investigated; some patients with on-going damage to their kidney are not actively treated … all because the investigation and management is, too often, not tailored to the specific findings for the patient.

All of medicine deserves the attention to detail (but not the hysteria) that has been directed to the COVID19 viral pandemic.