What is the best treatment for hydronephrosis?

Written by Zhou Qi
Nephrology
Updated on September 27, 2024
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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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What department to see for hydronephrosis?

Patients with hydronephrosis should visit the urology department of a formal hospital, because the conditions causing hydronephrosis are often surgical in nature. The most common cause is urological stones, which block the ureter or the bladder opening, causing urine to accumulate within the urinary system and leading to hydronephrosis. Additionally, patients with benign prostatic hyperplasia may also experience this condition. Tumors in the urinary system may compress the ureter and cause hydronephrosis. Some patients have congenital deformities of the ureter, where changes in the anatomical structure can lead to hydronephrosis. In summary, these conditions often require surgical treatment, thus necessitating consultation at a formal hospital's urology department.

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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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Can people with hydronephrosis drink water?

Whether patients with hydronephrosis can drink water depends on whether the hydronephrosis has been resolved. Hydronephrosis occurs due to a blockage in the urinary system, often caused by inflammation, scarring, or adhesions of the ureters, or by obstructions such as stones or tumors in the urinary tract, or possibly by an enlarged prostate, leading to the inability of the bladder to properly expel urine. In summary, when the urine produced by the kidneys cannot be properly expelled from the body, it leads to the expansion of the renal pelvis and calyces, known as hydronephrosis. Drinking water at this time can certainly aggravate the condition of hydronephrosis if the body is already struggling to expel fluids. Therefore, if this blockage remains unresolved, patients should limit their intake of fluids. However, if the obstruction is cleared and the urinary tract is smooth, allowing urine to be expelled normally, drinking water is permissible.

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Written by Zhou Qi
Nephrology
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What is hydronephrosis?

The so-called hydronephrosis is a morphological description, referring to an obstruction in the urinary system caused by various reasons. After the kidneys produce urine, it cannot be normally delivered to the bladder. This leads to fluid accumulation in the renal pelvis and calyces, which can be detected through imaging as hydronephrosis. The causes of hydronephrosis are numerous. The most common cause is acquired obstruction, primarily due to urinary system stones, scarring from injuries, or tumors in the urinary system compressing the ureter, which often results in urinary tract obstruction. In addition, some congenital causes can also lead to urinary tract obstruction. Examples include segmental dysfunction of the ureter, intrinsic stenosis of the ureter, and twisting of the ureter. However, these congenital obstruction causes are relatively rare.

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Nephrology
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What should I do about hydronephrosis?

Hydronephrosis is merely a consequence of urinary system diseases, indicating that the urine produced by the kidneys cannot be normally transported through the ureter to the bladder due to narrowing, adhesion, scarring, or obstruction somewhere. This causes the urine to accumulate in the renal pelvis and calyces. Therefore, the treatment of this disease requires identifying the cause, and then selecting a surgical treatment plan based on the situation. For instance, urinary system stones can cause hydronephrosis, and patients might need extracorporeal shock wave lithotripsy or open surgery for stone removal. Tumors in the urinary system can lead to hydronephrosis, and prostate hyperplasia can also cause similar symptoms, necessitating open surgery to resolve the obstruction. Some patients have congenital abnormalities, adhesions, or scars in the ureter, which might require surgical corrections of the ureter.