Whether congenital hydronephrosis of 30 years needs surgery or not needs to be decided in the light of the condition of the patient; if there is no significant increase in the fluid accumulation, no complication and normal renal function, then the patient can continue to be observed, whereas if the above changes occur, then the patient needs to be aggressively treated with surgery. The treatment of hydronephrosis needs to be considered according to the cause of the disease, the severity of hydronephrosis, the presence of complications and renal function. If there is no significant increase of fluid accumulation in the past 30 years, no discomfort such as low back pain, and normal renal function in regular checkups, then dynamic observation can be chosen, and surgical treatment is not necessarily needed. If the fluid accumulation is found to be increasing, or there is discomfort such as back pain or fever, or kidney function decreases, then active surgical treatment is needed to protect kidney function. Specific surgical methods should be considered in conjunction with the cause and condition of the disease. If the disease is caused by congenital pyeloureteral stenosis, the general procedure is to perform pyeloureteral dissecting and shaping; if the patient can not tolerate general anesthesia, nephrostomy can be considered under local anesthesia. Please consult a regular hospital and follow the advice of a specialist for different treatments for different conditions.