Hydronephrosis
Diagnosis |
Hydronephrosis
|
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Department |
Urology; Pediatric Urology
|
1. Start the referral process:
Use your own referral form or notes* or download one of our forms:
2. Gather records:
For adult referrals, Urology:
- Records from all providers previously treating Dx
For Pediatric Urology:
- Hydronephrosis (UPJ Obstruction) Bilateral - Mild SFU Grade II - UTD P1 (All Ages):
- Obtain all previous urologic images and reports
- PCP notes
- Prenatal notes and images
- Renal/Bladder Ultrasound
- UA
- Hydronephrosis, Bilateral (Moderate to Severe; SFU Grades III and IV; UTD P2-3) (All Ages):
- Obtain all previous urologic images and reports
- PCP notes
- Prenatal notes and images
- VCUG
- Renal/Bladder Ultrasound
- UA
- Hydronephrosis, Unilateral (Severe; SFU Grade 4; UTD P3) (0 to 6 Weeks):
- Obtain all previous urologic images and reports
- PCP notes
- Prenatal notes and images
- VCUG
- Renal/Bladder Ultrasound
- UA
- Hydronephrosis, Unilateral (Severe; SFU Grade 4; UTD P3) (6 Weeks to 1 Year):
- Obtain all previous urologic images and reports
- PCP notes
- Prenatal notes and images
- VCUG
- Renal/Bladder Ultrasound
- UA
- Mag3 renal scan with Lasix (with catheter) at OHSU before appointment unless done previously
- Hydronephrosis, Unilateral (Mild to Moderate; SFU Grades 1-3; UTD P1-2) (Newborn to 6 Months):
- Obtain all previous urologic images and reports
- PCP notes
- Prenatal notes and images
- Renal/Bladder Ultrasound
- UA
- Hydronephrosis, Unilateral (Mild to Moderate; SFU Grades 1-3; UTD P1-2) (6 Months and Older):
- Obtain all previous urologic images and reports
- PCP notes
- Prenatal notes and images
- Renal/Bladder Ultrasound within 4 weeks of Peds Uro appointment
- UA
- Hydronephrosis, Unilateral (Severe; SFU Grade 4; UTD P3) (1 Year and Older):
- Obtain all previous urologic images and reports
- PCP notes
- Prenatal notes and images
- Renal/Bladder Ultrasound
- UA
- Mag3 renal scan with Lasix (with catheter) at OHSU before appointment unless done previously
3. Fax the referral and all records to 503-346-6854.
* Referral notes or forms should include:
- Patient name, date of birth, sex, address and phone number
- Referring provider’s name, address and phone number
- Diagnosis or reason for referral
- Department patient is being referred to
- Most recent chart notes supporting the diagnosis or reason for referral
For help or to arrange provider-to-provider advice, call 503-494-4567.
Date Revised | May 01, 2024 |
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