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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What department should I go to for hydronephrosis?

Hydronephrosis refers to the accumulation of urine in parts such as the renal pelvis and calyces due to some reason causing the urinary system to not smoothly excrete urine. After the kidneys produce urine, it cannot be excreted smoothly, leading to the accumulation called hydronephrosis. Generally, it is necessary to visit the urology department, as the most common causes of hydronephrosis are stones or tumors in the urinary system and prostatic hyperplasia, among other issues, all of which require urological treatment. In most cases, surgery may be necessary to relieve the obstruction and resolve the hydronephrosis. However, there are also a small number of patients who may have hydronephrosis due to other reasons, such as cervical cancer or colorectal cancer patients, where enlarged tumors may compress the ureter leading to hydronephrosis. Patients with cervical cancer need to undergo surgical treatment in gynecology, while those with colorectal cancer may need treatment in general surgery.

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Written by Li Yuan Wei
Urology
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Is hydronephrosis of the second degree severe?

Hydronephrosis grade two, this "grade two" is likely a classification used in ultrasound or CT imaging. For hydronephrosis, the presence of condition itself indicates that the pathology has already affected kidney function. The most common causes include ureteral obstruction, or obstruction at the renal pelvis exit, typically due to stones or tumors, or narrowing caused by plastic tubes. Once hydronephrosis occurs, these conditions have already altered kidney function, necessitating further diagnosis to identify the cause, with surgery possibly being required. The most common objective assessment is a CT scan of the urinary system, with enhanced CT being the most accurate for understanding the severity of the hydronephrosis. Also, it helps identify the location of the ureteral obstruction, and thirdly, it can help ascertain the cause and provide treatment.

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Written by Chen Feng
Urology
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Is hydronephrosis prone to recurrence?

Whether hydronephrosis is prone to recurrence depends on the cause of the hydronephrosis. Common causes of hydronephrosis in clinical practice are as follows: First, urinary tract stones. When a stone is lodged in the ureter or urethra, it can cause urinary obstruction. The urine produced by the kidneys cannot be expelled in time, leading to hydronephrosis. If the stones in the urinary system can be completely removed, it generally does not recur easily. However, if there are still quite a few stones in the kidney or bladder after clearing the urinary tract, it is more likely to recur, because the stones might move down, get lodged in the ureter or urethra again, and cause hydronephrosis. Second, prostate enlargement. Hydronephrosis caused by prostate enlargement is generally more likely to recur because the prostate continues to grow in size. Even if the enlarged prostate is surgically removed, it still might lead to urethral stricture, thereby causing hydronephrosis again.

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Written by Zhou Qi
Nephrology
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What are the symptoms of hydronephrosis?

Patients with hydronephrosis may not exhibit any symptoms. Whether symptoms are present depends on factors such as the extent of renal damage caused by hydronephrosis, the severity of the hydronephrosis, and the duration of hydronephrosis. Some patients might only notice the issue due to a lump in the abdomen or a swelling sensation in the lower back, prompting them to undergo ultrasound imaging that reveals hydronephrosis. Hydronephrosis can cause renal colic, and patients may also experience nausea, vomiting, and reduced urine output. When hydronephrosis is complicated by infection, symptoms like chills, shivering, fever, and headache can occur. Some patients may first present clinically with a urinary tract infection, showing symptoms like fever, frequent urination, urgent urination, and painful urination. In rare cases, hydronephrosis can rupture and lead to bleeding.

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Written by Zhou Qi
Nephrology
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Is hydronephrosis with hematuria serious?

Whether hematuria in patients with hydronephrosis is serious cannot actually be determined by the amount of blood in the urine. It is important to identify the cause and assess kidney function, because hydronephrosis can lead to serious consequences, mainly kidney failure. If the hydronephrosis persists for a long time, it can compress the renal cortex and cause kidney shrinkage, leading to chronic kidney failure. The dangers of hematuria mainly include: first, it may cause significant bleeding, leading to anemia. Second, this type of hematuria could be caused by certain conditions, such as bleeding caused by a tumor in the urinary system, which is quite serious. Whereas bleeding caused by urinary tract infections or urinary system stones, in terms of the nature of the cause, is not considered very serious. However, significant bleeding can also lead to severe anemia and even shock, which would be more serious.