Hydronephrosis of pregnancy is a physiological phenomenon and usually asymptomatic. When it becomes associated with intractable or prolonged pain, infection refractory to antibiotics or extreme dilatation damaging the obstructed kidney, invasive intervention is necessary. Percutaneous nephrostomy is the procedure of choice for draining the acutely obstructed kidney early, rapidly and continuously. We present two cases of unusual severity, one of them being the first report of renal abscess formation complicating hydronephrosis of pregnancy. The role, advantages and some technical points of percutaneous nephrostomy are discussed.
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