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Chatting to Professor Henning Olsen, a Urologist with decades of experience in managing this renal condition. Read Full Transcript DPS PUJ obstruction [00:00:00] Welcome to Discover Paediatric Surgery. Andrew: My name is Andrew Grieve and I look forward to being your host today on this exciting episode. We are lucky to have Professor Henning Olsen today with us is a pediatric urologist from Denmark. And I can never pronounce his Hospital properly Aarhus, aahurs, but Aarhus, I definitely haven't got it. Henning: No one gets it right. Andrew: So Professor Olsen has two interests in life. The one is Urology and the other is sailing. But sadly today, we're going to talk a little bit about Urology and maybe next time it's about sailing. Thank you for [00:01:00] joining us. We appreciate your time. Sayo Henning. I mean, we'll just jump in we're going to talk about pelvic ureteric Junction obstructions and obviously in children. I mean in the first world there's obviously a lot of antenatal diagnosis of hydronephrosis does your unit get referred all the patients with this antenatal diagnosis for review or do you only see those that's end up having a problem later in life. Henning: Well it depends on and if they came from the local area, that means something like 500,000 we will see them and then they come from from outside of the country, which or referral area is something like three and a half million. They are seen in local hospitals and the prenatal diagnosis made there. And in case of a bilateral hydronephrosis, they come up [00:02:00] the questions and and often with bilateral hydronephrosis they are born in our Hospital. Unilateral hydronephrosis are born very normally and and get the follow-up after a schedule which we have in Danish Pediatric Society in the Danish Urological Society. It's very clear schedule how to handle these kind of of patients. So it's just in case in case of off bilateral hydronephrosis, then then they have to be referred to us. Andrew: So they're very early. Okay, do you ever get involved in antental counseling for these these parents? Henning: Well, if we talk about infra-vesicle obstruction means urethal valves. We are involved. Yes, because this is in some cases involve some some questions about continuing [00:03:00] the pregnancy and then the prognosis and what kind of surgery has to be done. And what's the prognosis after surgery? And what did what in general the parents have a very little understanding of course what the problem is and then they need some some discussion. Andrew: Just to give us an idea. I mean how many kids with hydronephrois that's noted antenatally, how many of those kids eventually come to surgery? Is it the majority of them or is it quite infrequent? Henning: No, it's is very infrequent, well not very but it's in the around 25 to 30 percent. We are very conservative in especially unilateral hydronephrosis. Andrew: And and I mean, you know, obviously there's a massive differential diagnosis for hydronephrosis. Do you know what portion in your unit eventually end up actually having a pelvouretheric junction obstruction out of all the antenatal hydronephrosis patients. [00:04:00] Henning: The majority the vast majority is UPJO (ureteric pelvic junction obstruction) . Of course it is, okay. You see reflex is is the next common cause of a kind of hydronephrosis but it's not so pronounced but in if you get trained in a way of looking at ultrasound their many, you know the AP diameter and they have calluses and then anything else but if you look at the ultrasound of a kidney in many cases...