☆ Do all pediatric hydronephrosis need treatment? I just attended a seminar on pediatric hydronephrosis, where experts from prenatal diagnosis, pediatric urology and eugenics, obstetrics and gynecology, ultrasound and other disciplines discussed that about half of the babies with hydronephrosis diagnosed by prenatal ultrasound can recover normally after birth, and the other half of the children with hydronephrosis do not need surgical treatment at postnatal follow-up. ☆ What types of pediatric hydronephrosis require surgery? Ultrasound is needed to find out whether the renal calyces are dilated, imaging is needed to find out the degree of pelvic-ureteral obstruction and hydronephrosis, and nephrogram is needed to find out the fractional kidney function. If the renal calyces are dilated, the parenchyma is thinned, and the fractional kidney function is 40% or less, surgery is considered. Is this true? No, depending on the degree of hydronephrosis and fractional kidney function, the best time for surgery is different for each child. Chao Min, Department of Pediatric Urology, Anhui Children’s Hospital ☆ Does surgery for hydronephrosis necessarily require kidney amputation? The vast majority of hydronephrosis does not require nephrectomy, and we have done many cases of fistula and anastomosis in small infants even if the kidney chart is not functional, and the function of the divided kidney has been restored to different degrees after surgery. ☆ Will the surgery affect the function of kidney in the future? The renal function will be improved to varying degrees after the surgery if the anastomosis is open. ☆ What are the main surgeries for pediatric hydronephrosis? ☆ When to use balloon dilatation followed by stent support? ☆ In what cases is pyeloplasty done? Most of our domestic patients use pyeloplasty, and more and more laparoscopic pyeloplasty has gradually replaced traditional open surgery. With the operator’s laparoscopic skills, it has obvious advantages in terms of surgical trauma, postoperative recovery, and cosmesis, and is now accepted by most. ☆ What is the choice between laparoscopic and traditional open surgery in pyeloplasty? ☆ What kind of pediatric hydronephrosis is not suitable for laparoscopic treatment? Renal pelvic cut within the sinus is not suitable for laparoscopic treatment. ☆ How to review after hydronephrosis surgery? What is the frequency and items of examination? If the child has fever, crying and restlessness, review the routine blood test, urine test, urinary ultrasound, etc. ☆ After severe hydronephrosis, why does diuretic nephrogram still indicate poor excretion? What should I do? ☆ Why does the hydronephrosis not disappear completely after surgery in some children? What should I do in this case? After pyeloplasty, the morphology of the dilated renal pelvis and calyces does not become normal, because the child develops like this during the embryonic period. The doctor finds the cause of the disease through examination and removes the cause through surgery, so that the anastomosis is open and the hydronephrosis does not further aggravate and affect the function of the affected kidney, and the disease is cured. Parents do not need to worry too much.