About Hydronephrosis

Overview

Hydronephrosis is a condition that occurs when there is a buildup of urine in the kidneys due to an obstruction in the urinary tract. This obstruction prevents urine from fully draining from the kidneys, causing the renal pelvis (the basin where urine collects) to become enlarged or dilated. Hydronephrosis can happen at any age, including in infants. Hydronephrosis can affect one or both kidneys and may be caused by various factors, such as kidney stones, an enlarged prostate, or muscle dysfunction near the connection of the urethra and bladder. In some cases, hydronephrosis may not cause any symptoms, but pain in the side of the back or groin is a common symptom. Treatment typically involves addressing the underlying cause of the obstruction to allow proper drainage of urine from the kidneys.

Causes and Risk Factors

Hydronephrosis is a condition that occurs when there is a blockage in the urinary tract, preventing proper drainage of urine from one or both kidneys. This blockage can result from various internal and external factors, leading to the swelling of the kidneys. Causes of hydronephrosis include:

• Sudden obstruction in one of the ureters: This is often caused by kidney stones, scarring, or blood clots
• Vesicoureteral reflux (VUR): Backflow of urine from the bladder into the kidneys due to a blocked ureter.
• Ureteropelvic junction obstruction: A kink in the area where the ureter meets the pelvis of the kidney
• Enlarged prostate gland: Common in men and can be due to conditions like benign prostatic hyperplasia (BPH) or prostatitis
• Pregnancy: Compression on the urinary tract due to a growing fetus
• Tumors or narrowings in or near the ureter

Risk factors for developing hydronephrosis include:

• Kidney stones
• Blood clots
• Previous surgery on the urinary tract
• Urinary tract cancer
• Urinary tract infections
• Pregnancy

It's important to note that while these risk factors can increase the likelihood of developing hydronephrosis, they do not guarantee its occurrence. If you have concerns about hydronephrosis or its risk factors, it's always best to consult with your healthcare professional for personalized advice.

Symptoms

Common symptoms of hydronephrosis include:

• Pain on the abdomen, sides (flank), and back
• Increased frequency of urination
• Increased urge to urinate
• Painful urination
• Nausea and vomiting
• Fever
• Cloudy urine
• Weak urine stream
• Bladder pain/ pain in the groin area
• Chills

It's important to note that some individuals with hydronephrosis may not experience any symptoms, especially in the early stages. For example, newborns with hydronephrosis may not show signs. If you suspect you have hydronephrosis or are experiencing any of these symptoms, talk to your doctor for further evaluation and appropriate treatment options.

Diagnosis

To diagnose hydronephrosis, health care professionals may perform the following examinations, tests, and procedures:

• Medical history: Health care professionals will review your symptoms, medical history, and medications.
• Physical exam: During a physical exam, a health care professional checks for signs such as an enlarged kidney or bladder or lumps or masses in the abdomen.
• Lab tests: These may include urinalysis, urine culture, full blood count, serum creatinine, and coagulation tests.
• Imaging:
  • Ultrasound of the pelvic and abdominal areas: Uses sound waves to view the urinary tract.
  • Magnetic resonance imaging (MRI) and computed tomography (CT) scans of the kidneys and other abdominal areas
  • Voiding cystourethrogram: Uses x-rays to show how urine flows through the bladder and urethra
  • Radionuclide scan: Creates images of the urinary tract as a radioactive substance passes through

It's important to consult with a health care professional for specific diagnosis recommendations tailored to individual circumstances.

Treatment Options

The goals of treatment for hydronephrosis are to relieve the obstruction, restore normal urine flow, and prevent further kidney damage. The specific treatment options depend on the underlying cause and severity of the condition.

Treatment options include:

• Watchful waiting (“wait and see”) for mild cases of hydronephrosis: Regular monitoring of symptoms is done to see if the condition improves on its own.
• Medications:
  • Antibiotics may be prescribed to control or prevent urinary tract infections associated with hydronephrosis.
  • Pain medications may be prescribed to manage any discomfort.
• Therapeutic procedures: Depending on the cause of the obstruction, various procedures may be performed to relieve it. These can include:
  • Inserting a ureteral stent or nephrostomy tube to allow urine drainage
  • Endoscopic surgery to remove kidney stones
  • Lithotripsy (use of shock waves) to break up kidney stones
  • Surgical removal of scar tissue or blockages

It is important to consult with a health care professional for personalized treatment recommendations. Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation and possible side effects from medications. Check with your health care professional or read the information provided with your medication for additional side effect information.