What is the best treatment for hydronephrosis?

Written by Zhou Qi
Nephrology
Updated on September 27, 2024
00:00
00:00

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.

Other Voices

doctor image
home-news-image
Written by Zhou Qi
Nephrology
55sec home-news-image

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.

doctor image
home-news-image
Written by Zhou Qi
Nephrology
47sec home-news-image

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.

doctor image
home-news-image
Written by Zhou Qi
Nephrology
45sec home-news-image

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.

doctor image
home-news-image
Written by Zhou Qi
Nephrology
56sec home-news-image

Will people with hydronephrosis have edema?

Hydronephrosis can potentially cause patients to exhibit symptoms of edema. Urine is produced by the kidneys and is expelled from the body through the urinary system, including the ureters and bladder. If there is an obstructive issue in the urinary system, the urine produced by the kidneys cannot be excreted smoothly, leading to hydronephrosis. When a large amount of fluid cannot be excreted, it eventually causes edema in the body. However, if the patient has hydronephrosis on only one side and the other kidney is healthy, the healthy kidney can fully compensate for the entire kidney function and sufficiently excrete fluids. Therefore, patients with unilateral hydronephrosis often do not show obvious signs of edema. But if a patient has bilateral hydronephrosis, and urine produced by both kidneys cannot be excreted, the patient will exhibit signs of edema.

doctor image
home-news-image
Written by Zhou Qi
Nephrology
41sec home-news-image

Causes of hydronephrosis

The so-called hydronephrosis often occurs because there is some factor in the patient's kidney or ureter that prevents the urine from being excreted smoothly, causing fluid accumulation and dilation in the renal pelvis, renal calyx, and ureter. The causes of this obstruction are often mechanical, such as urinary system stones, tumors, urinary tract deformities, or compression of the ureter caused by enlargement or tumors in nearby organs of the urinary system. In a few cases, it may also be related to a decline in the function of the ureter itself, such as a neurogenic bladder, ureteral reflux, or decreased ureteral motility.