Hydronephrosis medical therapy

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Hydronephrosis Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2]

Overview

The goal of treatment for hydronephrosis is to restart the free flow of urine from the kidney and decrease the swelling and pressure that builds up and decreases kidney function.The initial care for the patient is aimed at minimizing pain and preventing urinary tract infections. Otherwise, surgical intervention may be required.

Medical Therapy

  • In order to reduce the risk of permanent kidney injury, the blockage of urine may need to be drained if hydronephrosis is severe enough.[5]
  • It is recommended to give pain medications and antibiotics to be patient before initiating the surgical intervention.

Mild to moderate hydronephrosis in adults

Severe hydronephrosis

  • Surgery may be the treatment of choice to eliminate the severity of the blockage or even correct the reflux.

Bilateral hydronephrosis

Severe unilateral hydronephrosis in infants

Moderate and mild unilateral hydronephrosis in infants

Antibiotic prophylaxis

References

  1. Gharib T, Mohey A, Fathi A, Alhefnawy M, Alazaby H, Eldakhakhny A (July 2018). "Comparative Study between Silodosin and Tamsulosin in Expectant Therapy of Distal Ureteral Stones". Urol. Int.: 1–6. doi:10.1159/000490623. PMID 30025399.
  2. Onen A (June 2007). "An alternative grading system to refine the criteria for severity of hydronephrosis and optimal treatment guidelines in neonates with primary UPJ-type hydronephrosis". J Pediatr Urol. 3 (3): 200–5. doi:10.1016/j.jpurol.2006.08.002. PMID 18947735.
  3. Onen A, Jayanthi VR, Koff SA (September 2002). "Long-term followup of prenatally detected severe bilateral newborn hydronephrosis initially managed nonoperatively". J. Urol. 168 (3): 1118–20. doi:10.1097/01.ju.0000024449.19337.8d. PMID 12187248.
  4. Nonomura K, Yamashita T, Kanagawa K, Itoh K, Koyanagi T (June 1994). "Management and outcome of antenatally diagnosed hydronephrosis". Int. J. Urol. 1 (2): 121–8. PMID 7627847.
  5. Li F, Zhang MZ, Liu TC (February 1994). "[Diagnosis and treatment of hydronephrosis: report of 100 cases]". Zhonghua Wai Ke Za Zhi (in Chinese). 32 (2): 114–6. PMID 7924663.
  6. Belarmino JM, Kogan BA (January 2006). "Management of neonatal hydronephrosis". Early Hum. Dev. 82 (1): 9–14. doi:10.1016/j.earlhumdev.2005.11.004. PMID 16427220.
  7. Onen A (December 2007). "Treatment and outcome of prenatally detected newborn hydronephrosis". J Pediatr Urol. 3 (6): 469–76. doi:10.1016/j.jpurol.2007.05.002. PMID 18947797.
  8. Konda R, Sakai K, Ota S, Abe Y, Hatakeyama T, Orikasa S (May 2002). "Ultrasound grade of hydronephrosis and severity of renal cortical damage on 99m technetium dimercaptosuccinic acid renal scan in infants with unilateral hydronephrosis during followup and after pyeloplasty". J. Urol. 167 (5): 2159–63. PMID 11956470.
  9. Armadá Maresca M, Rivilla Parra F, Viña Simón E, García Casillas J (May 1997). "[Diagnosis and treatment of neonatal hydronephrosis. Influence of prenatal diagnosis]". An. Esp. Pediatr. (in Spanish; Castilian). 46 (5): 483–6. PMID 9297403.
  10. González R, Schimke CM (1998). "[The prenatal diagnosis of hydronephrosis, when and why to operate?]". Arch. Esp. Urol. (in Spanish; Castilian). 51 (6): 575–9. PMID 9773587.
  11. Becker A, Baum M (January 2006). "Obstructive uropathy". Early Hum. Dev. 82 (1): 15–22. doi:10.1016/j.earlhumdev.2005.11.002. PMID 16377104.
  12. Estrada CR (July 2008). "Prenatal hydronephrosis: early evaluation". Curr Opin Urol. 18 (4): 401–3. doi:10.1097/MOU.0b013e328302edfe. PMID 18520762.
  13. Nonomura K, Yamashita T, Kanagawa K, Itoh K, Koyanagi T (June 1994). "Management and outcome of antenatally diagnosed hydronephrosis". Int. J. Urol. 1 (2): 121–8. PMID 7627847.
  14. Becker A, Baum M (January 2006). "Obstructive uropathy". Early Hum. Dev. 82 (1): 15–22. doi:10.1016/j.earlhumdev.2005.11.002. PMID 16377104.

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