Hydronephrosis After Pyeloplasty: Failure or Remodeling?

Persistent hydronephrosis after pediatric pyeloplasty often alarms families and clinicians. But residual dilation does not always mean persistent obstruction.In this episode, we discuss how to interpret postoperative ultrasound, why complete resolution is uncommon, when APD reduction is reassuring, and when worsening hydronephrosis should trigger renewed evaluation.The central idea: after pyeloplasty, the question is not whether the pelvis still looks dilated. The question is whether the kidney is moving toward safety or back toward risk.Keywords: UPJO, pyeloplasty, hydronephrosis, pediatric urology, postoperative ultrasound, MAG3 renography.