Waching daily Mar 20 2017

Hydronephrosis is the swelling of a kidney due to a build-up of urine.

It happens when urine cannot drain out from the kidney to the bladder from a blockage

or obstruction.

Hydronephrosis can occur in one or both kidneys.

The main function of the urinary tract is to remove wastes and fluid from the body.

The urinary tract has four parts: the kidneys, the ureters, the bladder and urethra.

The urine is formed when the kidneys filter blood and remove excess waste materials and

fluid.

Urine collects into a part of the kidney called the renal pelvis.

From the renal pelvis, the urine travels down a narrow tube called the ureter into the bladder.

The bladder slowly fills up with urine, which empties from the body through another small

tube called the urethra.

Hydronephrosis occurs when there is either a blockage of the outflow of urine, or reverse

flow of urine already in the bladder (called reflux) that can cause the renal pelvis to

become enlarged.

What are the symptoms of hydronephrosis?

Here may or may not be direct symptoms of hydronephrosis depending upon the underlying

cause.

Individuals with acute hydronephrosis, for example symptoms from renal colic due to a

kidney stone begin with an acute onset of intense flank or back pain radiating to the

groin, associated with nausea, vomiting, and sweating.

Colicky pain comes and goes and its intensity may cause the person to writhe or roll around

or pace in pain.

There may be blood seen in the urine.

Chronic hydronephrosis develops over time and there may be no specific symptoms.

Tumors in the pelvis or bladder obstruction may develop silently and the person may have

symptoms of kidney failure.

These are often nonspecific and may include weakness, malaise, chest pain, shortness of

breath, leg swelling, nausea and vomiting.

If electrolyte abnormalities occur because the kidneys are unable to regulate sodium,

potassium, and calcium, there may be heart rhythm disturbances and muscle spasms.

What causes hydronephrosis?

There are many causes of hydronephrosis.

In adults, the conditions that most often cause hydronephrosis include:

Kidney stones—Salts and minerals that are present in urine can form small hard stones

that may become lodged in the kidneys or urinary tract.

Cancer—Tumors in the bladder, prostate gland, uterus or other organs that are part of or

near the urinary tract may cause blockages that disrupt the flow of urine.

Benign prostatic hyperplasia (BPH)—Enlargement of the prostate gland in men can cause pressure

on the urethra, the tube that urine passes through before it leaves the body.

Other possible causes of hydronephrosis include:

Blood clots in the kidney or ureter.

Narrowing or stricture of the urinary tract due to injury, infection, birth defects or

surgery.

Nerve or muscle problems that affect the kidneys or ureters.

Urinary retention due to an inability to empty the bladder.

Vesicoureteral reflux, when urine flows backward from the bladder to the kidneys.

Uterocele, when the lower part of the ureter may protrude into the bladder.

How is hydronephrosis treated?

The aim of treatment is to restore the flow of urine from the kidney and to decrease the

swelling and pressure caused by fluid build-up.

There are several approaches to treating the condition, depending on the underlying cause

of the problem.

You should discuss treatment options with your healthcare provider.

If the hydronephrosis is acute or sudden, a stent or soft tube (nephrostomy tube) may

be inserted into the kidney to drain off excess urine.

A soft plastic tube called a ureteral stent may be placed between the kidney and bladder

to drain excess fluids.

If hydronephrosis is caused by stones in the kidneys or ureters these must be treated with

shock wave lithotripsy, ureteroscopy or surgery.

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