symptoms of hydronephrosis infection

Written by Zhou Qi
Nephrology
Updated on September 12, 2024
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In cases of hydronephrosis, urinary tract infections are common, and these infections primarily manifest as pyelonephritis. The presence of fluid in the kidneys indicates that urine cannot be excreted smoothly, leading to an obstruction in the urinary tract. Therefore, bacteria can easily multiply in this area because normal urine, if it can be excreted smoothly, also serves to flush the urinary system, preventing the growth of bacteria. Thus, when fluid accumulates, pyelonephritis can easily occur, with the main symptoms being back pain and fever. If cystitis is also present, the patient will experience symptoms such as frequent urination, urgent urination, and painful urination. Hydronephrosis may be caused by issues such as urinary system stones or tumors, which can also lead to clinical symptoms like back pain and hematuria.

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Written by Zhou Qi
Nephrology
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What should I do if I have hydronephrosis and atrophy?

Hydronephrosis leading to kidney shrinkage indicates that the condition has persisted for a long time. Long-term hydronephrosis places significant pressure on the kidneys, which in turn compresses the kidney tissues causing tissue shrinkage. The destruction and shrinkage of tissues result in the kidneys' inability to function properly, leading to azotemia. Patients will experience chronic kidney failure, a situation that is difficult to reverse. Even if surgery is performed to relieve the obstruction and allow urine to be excreted, the damaged kidney tissue cannot regenerate. Therefore, it is still necessary to relieve the obstruction as soon as possible to avoid further damage to the remaining kidney tissue. For patients who have progressed to uremia, it may be necessary to consider hemodialysis or peritoneal dialysis, or undertake a kidney transplant to sustain life.

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How is hydronephrosis caused?

The causes of hydronephrosis can be divided into congenital, acquired, and external factors. Among these, acquired causes are the most common, primarily referring to obstructions in the urinary tract, such as stones that block the ureter, leading to hydronephrosis, inflammation, or ischemic damage. Scarring of the ureter can also result in hydronephrosis. Tumors or polyps in the renal pelvis and ureter may also cause obstructions leading to fluid accumulation. External causes mainly include diseases of retroperitoneal organs, such as abscesses, bleeding, tumors in the retroperitoneum, and pelvic tumors, like rectal cancer. Congenital causes mainly involve intrinsic narrowing of the ureter, ectopic vessels causing compression, and high insertion of the ureter, which are less common.

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How is hydronephrosis treated?

The treatment of hydronephrosis often requires surgery. Decisions about diagnosis and treatment plans should be based on clinical symptoms, the duration of the obstruction, the location of the obstruction, and whether there is an infection. Since hydronephrosis is typically caused by a pathological factor that blocks the ureter, surgery is often necessary to remove the obstruction in order to address the hydronephrosis and prevent further damage to kidney function. The principle of the surgery is that if the obstruction is minor, a simple corrective surgery may suffice. However, if the dilation of the ureter and renal pelvis is very significant, a reanastomosis of the ureter and renal pelvis might be needed.

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Hydronephrosis should be seen by the Urology Department.

Hydronephrosis requires consultation at the urology department of a formal public hospital. Hydronephrosis refers to the situation where urine produced by the kidneys cannot be smoothly excreted. The primary reason is usually due to obstructions in the urinary tract below the kidneys, such as in the ureter or bladder. Obstructive factors primarily include stones, tumors, prostate enlargement in men, scarring or adhesions in the ureter, or inadequate ureteral motility, among others, often necessitating urologic intervention. These obstructive factors usually require surgical removal, such as using ultrasonic lithotripsy for stones or direct surgical intervention, thus necessitating a visit to urology.

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What are the symptoms of hydronephrosis?

Hydronephrosis is often due to obstructive factors in the urinary system, such as stones, tumors, prostate hyperplasia, etc., causing urine to not be excreted smoothly, so patients may have symptoms related to obstructive kidney disease. Since the kidney is in a state of water accumulation, the ureter may experience spasms, so patients may experience pain in the lower back area. Especially in patients with kidney stones leading to hydronephrosis, as these kidney stones can cause severe pain. Furthermore, patients may experience hematuria. If the hydronephrosis is bilateral, it can lead to a sudden decrease in urine output and acute renal failure.