What are the symptoms of hydronephrosis?

Written by Zhou Qi
Nephrology
Updated on September 01, 2024
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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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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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Written by Chen Feng
Urology
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What foods can be eaten with hydronephrosis?

Patients with hydronephrosis should pay attention to a light diet, eat more fresh vegetables and fruits, avoid spicy and stimulating foods, and consume less high-salt foods, while also abstaining from alcohol. Besides controlling their diet, patients with hydronephrosis should also actively search for the underlying causes of the condition. Common causes of hydronephrosis in clinical practice include urinary tract stones or prostate hyperplasia, mainly due to obstructions in the ureter or urethra, preventing the urine produced by the kidneys from being excreted, which then leads to hydronephrosis. Once the cause of the urinary obstruction is identified, it is necessary to actively treat the underlying cause to restore the patency of the urinary tract. After the condition improves, it is also important to drink more water and urinate frequently to maintain health.

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Written by Li Liu Sheng
Nephrology
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How is hydronephrosis detected?

The kidneys have a very strong compensatory ability. In the early stages of hydronephrosis, the amount of fluid may not be large, or the duration may not be long, and usually, the patient may have no symptoms. Hydronephrosis is often discovered during health examinations or through ultrasound or CT scans performed during hospital stays. Of course, if the hydronephrosis persists for too long and the volume is very large, the patient can gradually feel discomfort or a distended sensation in the lower back or upper abdomen. Moreover, if the hydronephrosis is caused by kidney stones, the patient often experiences severe back pain, and there might even be visible blood in the urine. Hydronephrosis can also lead to symptoms of urinary tract infections such as frequent urination, urgent urination, and painful urination. Prolonged hydronephrosis can lead to a decline in kidney function, resulting in symptoms like fatigue, loss of appetite, and poor overall health. Therefore, it is crucial for patients to undergo regular ultrasound examinations of the kidneys to detect hydronephrosis early.

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Written by Zhou Qi
Nephrology
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What is the best treatment for hydronephrosis?

The so-called hydronephrosis often occurs due to some factor blocking the urinary system, causing urine to not be excreted normally. The most common cause is urinary system stones, but it can also be due to issues like tumors or benign prostatic hyperplasia. The treatment for stones depends on the size of the stone. Stones smaller than 5 millimeters in diameter can often pass naturally. If the stone is 7 to 15 millimeters in diameter, extracorporeal shock wave lithotripsy is typically used. If stones in the lower mid-ureter do not respond well to medication, retrograde removal under cystoscopy can also be performed. For some patients who have had a long-standing obstruction, renal function may already be impaired. If the obstruction cannot be relieved, surgeries such as creating a urinary diversion can be performed. This includes procedures like bladder fistulation, pyelostomy, or percutaneous ureterostomy, among others.

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Written by Zhou Qi
Nephrology
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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.