Hydronephrosis is a condition in which one or both kidneys begin to swell. This swelling is due to the inability of urine to drain from the kidney. Hydronephrosis is typically caused by a blockage of the ureters, the tubes through which urine drains from the kidneys. In some instances, anatomical defects can be the cause. This condition can affect patients of any age. Infants can even have hydronephrosis before birth. In some cases, there are no symptoms present whatsoever.
There are generally two causes of hydronephrosis. One is blockages where the kidney meets the ureter. These blockages can also occur when the ureter meets the bladder, but this is less common.
Vesicoureteral reflux is another potential cause, where urine backs up from the bladder to the kidney. That is a reversal of the typical flow, where urine only proceeds from the kidney to the bladder.
The most common symptoms of hydronephrosis include:
- A pain in the back or side, which may travel to the groin or lower abdomen
- Pain during urination
- Frequent or urgent need to urinate
- Nausea or vomiting
In some cases, patients don’t experience any symptoms during hydronephrosis.
If a doctor suspects hydronephrosis after a patient comes in with urinary issues or pain, a general practitioner will likely refer the patient to a urologist for closer evaluation. The first tests to be performed are a blood test that verifies kidney function and a urine test to check for urinary tract infections or urinary stones.
A CT Scan may also be ordered if an ultrasound does confirm dilation of the kidneys to get more information about where a blockage may be located.
Hydronephrosis often goes undiagnosed and usually resolves itself over time. In cases where treatment is required, the common interventions include surgery for severe cases and preventative antibiotics for more mild cases.
Treatment for Severe Hydronephrosis
In some cases, hydronephrosis can severely impact kidney function. In instances of severe hydronephrosis or cases where there is significant reflux from the bladder, surgery may be the best option. If untreated, hydronephrosis of this type can permanently damage the kidney.
Hydronephrosis typically only affects one kidney. As a result, the other (unaffected) kidney can still function. In some cases, this condition can lead to kidney failure. In patients who have lost a kidney or have weakened kidneys, the condition is far more severe.
Treatment for Moderate Hydronephrosis
In many cases, the physician might decide that the best course of action is to wait and see how the hydronephrosis develops. There is an increased risk of urinary tract infections during hydronephrosis, so the physician may prescribe a preventative course of antibiotics to help you avoid infection.