Hydronephrosis should be seen by the Urology Department.

Written by Zhou Qi
Nephrology
Updated on September 02, 2024
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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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Written by Zhou Qi
Nephrology
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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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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.

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Can you have sex with hydronephrosis?

Before the complete resolution of hydronephrosis, it is recommended that patients avoid sexual intercourse. This is because hydronephrosis indicates the presence of obstructive factors in the urinary system, causing urine to not be excreted smoothly. Urine accumulates within the urinary system, causing dilation of the renal pelvis, calyces, and ureter. If urine cannot be excreted, bacteria can easily ascend from the urethral opening into the urinary system, causing an inflammatory response. If patients engage in sexual intercourse during this time, bacteria at the urethral opening can easily be pressed into the bladder, ascending and potentially causing pyelonephritis or cystitis. Therefore, it is best for such patients to avoid sexual intercourse until the hydronephrosis has been thoroughly addressed.

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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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Does hydronephrosis hurt a lot?

Hydronephrosis does not necessarily cause severe pain. If the hydronephrosis develops suddenly over a short period, it might cause intense pain, most commonly due to urinary system stones blocking the ureter, leading to hydronephrosis. At this time, the ureter may experience spasms, causing severe pain. However, if the hydronephrosis develops gradually, the patient's pain symptoms might not be pronounced. For example, insufficient motility of the ureter or some type of narrowing could lead to the accumulation of fluid. If this condition develops slowly and persists for a long time, the patient might not feel particularly uncomfortable, despite the hydronephrosis, and it may only be discovered incidentally during a physical examination.