Hydronephrosis is a condition in which the kidneys are swollen due to the obstruction of urine flow in any part of the urinary tract. Hydronephrosis is also referred to as “water inside the kidney”. The word hydronephrosis can be broken down in medical terms as follows: the term “hydro” represents “water”, the term “nephron” represents “kidney”, and the term “sis” represents “an action, process, state, or condition” Hydronephrosis is not a disease itself, but rather a condition that occurs with a disease. Hydronephrosis can be the result of several different abnormalities.
In general the cause results from an obstruction located at the junction of the ureter and renal pelvis. It can also be the cause of reflux, which is urine flowing back into the kidneys from the bladder. In a normal healthy body urine flows out of the kidney at extremely low pressure. If the flow of urine is obstructed, then the urine backs up behind the point at which is blocked. The urine eventually reaches the small tubes of the kidney and the renal pelvis (collecting area) stretching the kidney and increasing the pressure on its internal structures.
The increased pressure from the obstruction may damage the kidney and more importantly result in loss of its function. Because of the obstruction of urine urinary tract infections are caused, and kidney stones are likely to be formed. If both kidneys are obstructed kidney failure may result. Some structural abnormalities of the area between the kidney, ureter, and bladder occur during fetal development. Some of the known defects have been identified as inherited conditions, but tests have not determined this exactly.
Other structural abnormalities can be caused by injury, surgery, or radiation therapy, among the few possibilities. Hydronephrosis in children is usually never diagnosed until symptoms start to occur. With today’s technology this condition can often be detected during pregnancy. In most instances where this condition (hydronephrosis) is detected during pregnancy, it most likely corrects itself by the time or soon after the child is born. This condition can be diagnosed as being mild, moderate, or severe. This is based on how much the kidney is stretched and also how much the urinary flow is impaired.
Hydronephrosis can be unilateral, affecting one kidney or bilateral, affecting both kidneys. The following are a list of various conditions that may cause hydronephrosis: * Kidney stones * Blood clot * Scarring of the ureter * Enlarged prostate * Enlarged uterus during pregnancy Symptoms may or may not be present with this condition. If symptoms are occurring the patient would most likely experience any of the following: * Pain in the back, wrist, groin, lower abdomen * Fever * Nausea and vomiting * Unexplained itching * Dribbling after urination * Increased urge to urinate, or urinary incontinence
Blood in the urine is another symptom that may be experienced by some. Blood in the urine is not normal and should not be ignored. Anyone experiencing this should contact their health provider as soon as possible. The diagnosing of hydronephrosis can relatively be easy. In most cases of pediatric patients prenatal diagnosis is usually possible. On the other hand sometimes the diagnosis is difficult and is only found during the evaluation of a patient complaining of weakness. In pediatric cases hydronephrosis is usually detected by routine ultrasounds during pregnancy.
In other instances the diagnosis of this condition begins with questioning the patient about the history of the signs and symptoms they have or are experiencing. Depending on the outcome of the questions further tests may need to be ordered. The patient’s medical history as well as their family history may be helpful when diagnosing this condition. There are various laboratory tests that can be done to diagnose hydronephrosis. * Urinalysis * Complete Blood Count * Electrolyte Analysis * BUN (Blood Urea Nitrogen) Once there has been a diagnosis, the next phase involves treatment.
The treatment of hydronephrosis focuses on the removal of whatever is causing the obstruction, and treatment to restart the free flow of urine from the kidney. In some cases the treatment may include placing a catheter through a restricting prostate, or in more complicated cases removing a cancerous bladder, and rebuilding a new one with a piece of bowel. If the kidney is damaged too badly it may have to be removed. The initial care for the patient is aimed at minimizing pain and preventing urinary tract infections. In most cases the treatment plan or path that the health care provider takes is usually successful.
There are some complications of hydronephrosis that should be taken under consideration. If this condition remains untreated, the increased pressure within the kidney may decrease the ability of the kidney to filter blood, remove waste products, and make urine as well as regulate electrolytes in the body. There is really no particular prevention of this condition because it’s caused by an underlying effect of another abnormality. Prevention depends on avoiding the underlying cause. For example, individuals with kidney stones may try to decrease the chance for further kidney stones by trying to stay well hydrated.