Urine Blockage in Newborns (cont.)
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Treatment for urine blockage depends on the cause and severity of the blockage. Hydronephrosis discovered before the baby is born will rarely require immediate action, especially if it is only on one side. Often the condition goes away without any treatment before birth or sometimes after. The doctor will keep track of the condition with frequent ultrasounds. With few exceptions, treatment can wait until the baby is born.
If the urine blockage threatens the life of the unborn baby, the doctor may recommend a procedure to insert a small tube, called a shunt, into the baby's bladder to release urine into the amniotic sac. The placement of the shunt is similar to an amniocentesis, in that a needle is inserted through the mother's abdomen. Ultrasound guides the placing of the shunt. This fetal surgery carries many risks, so it is performed only in special circumstances, such as when the amniotic fluid is absent and the baby's lungs aren't developing or when the kidneys are very severely damaged.
Antibiotics are medicines that kill bacteria. A newborn with possible urine blockage or VUR may be given antibiotics to prevent urinary tract infections from developing until the urinary defect corrects itself or is surgically corrected.
If the urinary defect doesn't correct itself and the child continues to have urine blockage, surgery may be needed. The decision to operate depends upon the degree of blockage. The surgeon will remove the obstruction to restore urine flow. A small tube, called a stent, may be placed in the ureter or urethra to keep it open temporarily while healing occurs.
If the child has urine retention because of nerve disease, the condition may be treated with intermittent catheterization. The parent, and later the child, will be taught to drain the bladder by inserting a thin tube, called a catheter, through the urethra to the bladder. Emptying the bladder in this way helps prevent kidney damage, overflow incontinence, and urinary tract infections.
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