RESUMEN
To study the clinical presentation and management of giant hydronephrosis. Civil Hospital Dadu and Urology Department SMBBMU Larkana. March 2004 to March 2011. 28 patients with giant hydronephrosis treated. 18[64.3%] patients had unilateral and [27.1%] had bilateral pelvi ureteric junction obstruction, 4[14.3%] had ureteric stones and remaining 4[14.3%] had multiple renal stones. All patients were treated with definitive surgery ie pyeloplasty, nephroplication, ureterolithotomy, extended pyelolithotomy and nephrectomy. Six [21.4%] patients had elevated blood urea and serum creatinine level so initially treated by percutaneous nephrostomy and ureteric catheterization. 10 out of 28 cases of giant hydronephrosis showed improvement in the function and drainage as well as pelvi-calyceal system dilatation while 28 patients going for nephrectomy. Early referral and intervention is necessary for giant hydronephrosis to prevent infection and deterioration of renal function