The presentation and management of neonatal obstructive uropathies.

The existence of a congenital urinary obstruction may be suggested when routine examination of the newborn infant reveals such signs as enlargement of one or both kidneys, distension of the bladder or slow, dribbling micturition. The paediatrician should also be alerted to the possibility of obstructive uropathy when there are present non-urological congenital anomalies which often secondarily involve the urinary tract or which are known commonly to co-exist with congenital urinary tract lesions. Secondary involvement, with obstruction, of the urinary tract occurs with space-occupying masses in the pelvis such as hydrometrocolpos or a large intrapelvic component of a sacrococcygeal teratoma. The pelvic tumour, by displacing the bladder, leads to chronic urinary retention and upper tract dilatation. A congenital retroperitoneal teratoma may displace laterally, and obstruct, one or both ureters. Examples of congenital anomalies which frequently coincide with congenital urological lesions include the following.