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Hydronephrosis—Adult

  • Definition

    Hydronephrosis a build-up of urine in the kidneys. The kidneys swell from the excess urine which cannot drain into the bladder. The condition may affect one or both kidneys. Hydronephrosis is not a disease, but a symptom of a problem with the urinary system.
    Kidney, Ureter, Bladder, and Kidney Stone
    IMAGE
    Copyright © Nucleus Medical Media, Inc.
  • Causes

    Hydronephrosis is caused by one of two problems in the urinary system:
  • Risk Factors

    Factors that may increase your chance of hydronephrosis include:
    • Defect in the urinary system that is present at birth
    • Scarring of the ureters, the tubes that carry urine from the kidneys to the bladder
    • Cancers in the pelvic area (bladder, cervix, colon, or prostate)
    • Persistent kidney or urinary tract infections
    • Blood-clotting disorders
    • Benign prostatic hyperplasia
    • Neurogenic bladder
    • Injury to structures in the urinary system, such as from surgery or trauma
    • Enlarged uterus during pregnancy
  • Symptoms

    Hydronephrosis may or may not cause any symptoms. If symptoms occur, they may include:
    • Pain in the back, waist, lower abdomen, or groin
    • Persistent pain with urination or urinary frequency from urinary tract infections
    • Increased urge to urinate or urinary incontinence
    • Incomplete urination
    • Fever
    • Nausea and vomiting
    • Unexplained itching
  • Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done. It may include a pelvic or rectal exam to feel for blockages. You may be referred to a urologist and/or nephrologist for further diagnosis and treatment.
    Tests may include:
    • Blood tests
    • Urine tests
    Imaging tests evaluate the urinary system. This can be done with:
  • Treatment

    A catheter may be inserted into the bladder to drain excess urine from the kidney. Some causes of hydronephrosis resolve without treatment, such as pregnancy and kidney stones.
    Treatment options include:
    Medications
    Depending on the cause, hydronephrosis may be treated with:
    • Antibiotics for infection
    • Medications for neurogenic bladder or to reduce excess uric acid excretion
    Surgery
    Surgery is usually not needed, but it may be necessary in some cases. Procedures may include:
    • Removing a blockage or correcting a defect in the urinary system
    • Nephrostomy—A catheter is placed into the kidney. The catheter is attached to a urine collection bag.
    • Nephrectomy—Removal of part or all of the kidney (rare).
  • Prevention

    In general, the causes of hydronephrosis cannot be prevented. Prompt treatment of conditions that cause hydronephrosis reduces the risk of complications, such as kidney failure.
  • RESOURCES

    National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov

    National Kidney Foundation http://www.kidney.org

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca

    Kidney Foundation of Canada http://www.kidney.ca

    References

    Hydronephrosis. National Kidney Foundation website. Available at: https://www.kidney.org/atoz/content/hydronephrosis. Accessed July 12, 2013.

    Kidney disease and kidney failure. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/health-topics/kidney-disease/Pages/default.aspx. Updated November 15, 2012. Accessed July 12, 2013.

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