Hydronephrosis (patient information)

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For the WikiDoc page for this topic, click here

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

Overview

Hydronephrosis is the enlargement of the parts of the kidney that collect urine. Bilateral means both sides. Unilateral means single side.

What are the Symptoms of Hydronephrosis?

Common symptoms in adults may include:

  • Back pain
  • Nausea, vomiting
  • Fever
  • Need to urinate often
  • Decreased urine output
  • Blood in the urine

What Causes Hydronephrosis?

Hydronephrosis occurs when urine is unable to drain from the kidney into the bladder. Hydronephrosis is not itself a disease. It occurs as a result of a problem that prevents urine from draining out of the kidneys, ureters, and bladder. Disorders linked with bilateral hydronephrosis include:

  • Acute bilateral obstructive uropathy - sudden blockage of the kidneys
  • Bladder outlet obstruction - blockage of the bladder, which does not allow drainage
  • Chronic bilateral obstructive uropathy - a gradual blockage of both kidneys is most often from a common singular obstruction
  • Neurogenic bladder - poorly functional bladder
  • Posterior urethral valves - flaps on the urethra that causes poor emptying of the bladder (in boys)
  • Prune belly syndrome - poorly emptying bladder that causes distention of the belly
  • Retroperitoneal fibrosis - increased scar tissue that blocks the ureters
  • Ureteropelvic junction obstruction - blockage of the kidney at the point where the ureter enters the kidney
  • Vesicoureteric reflux - backup of the urine from the bladder up to the kidney
  • Uterine prolapse - when the womb (uterus) drops down and presses into the vaginal area

Who is at Highest Risk?

Common risk factors include:

  • Pregnancy
  • Trauma
  • Pelvic radiation
  • Strictures
  • Neurogenic bladder
  • Urinary tract infection

Diagnosis

The following tests can show bilateral hydronephrosis:

  • CT scan of the abdomen or kidneys
  • IVP (used less often)
  • Pregnancy (fetal) ultrasound
  • Renal scan
  • Ultrasound of the abdomen or kidneys

When to Seek Urgent Medical Care?

Call your health care provider if:

  • You develop symptoms of hydronephrosis
  • You have hydronephrosis and the symptoms continue despite treatment

Treatment Options

  • Placing a tube into the bladder (Foley catheter) may open the blockage. Other treatments include:
    • Draining the bladder
    • Relieving pressure by placing tubes in the kidney through the skin
    • Placing a tube (stent) through the ureter to allow urine to flow from the kidney to bladder
    • The underlying cause of the blockage needs to be found and treated once the buildup of urine is relieved.

Where to find Medical Care for hydronephrosis?

Medical care for hydronephrosis can be found here.

Prevention

  • An ultrasound during pregnancy can show a blockage in the baby's urinary tract. This allows the problem to be treated with early surgery.
  • Other causes of blockage, such as kidney stones, can be detected early if people notice warning signs of kidney problems.
  • It is important to pay attention to general problems with urination.

What to Expect (Outlook/Prognosis)?

  • Surgery performed while the baby is in the womb or shortly after birth can have good results in improving kidney function.
  • Return of renal function can vary, depending on the length of obstruction.

Possible Complications

Irreversible kidney damage may result from conditions that cause hydronephrosis.

Sources

https://medlineplus.gov/ency/article/000474.htm


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