Hydronephrosis

Diagnosis
Hydronephrosis
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