Is hydronephrosis prone to recurrence?

Written by Chen Feng
Urology
Updated on April 16, 2025
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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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Does hydronephrosis cause pain?

Patients with hydronephrosis do not all experience pain. In fact, only a minority of patients experience pain. Hydronephrosis is caused by some form of urinary obstruction, such as urinary system stones, tumors, or problems like prostate enlargement, which prevent urine from being excreted smoothly. In this case, the accumulation of fluid can be a long-term, gradual buildup. Patients often adapt to the progression of the condition and do not exhibit obvious symptoms, especially in the early stages. However, some patients may experience pain, such as those with urinary system stones, or pain may occur when a tumor ruptures.

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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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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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How to relieve nausea caused by hydronephrosis?

Hydronephrosis with nausea can be caused by various reasons, so alleviating nausea symptoms requires specific analysis based on the specific cause. Patients with hydronephrosis often seen in hospital beds are mostly those with ureteral stones. When the stone is lodged in the ureter, the patient will experience an obstruction of urine outflow, leading to hydronephrosis. Moreover, a stone stuck in the ureter can cause renal colic, manifested as back pain, and may also be accompanied by symptoms of nausea and vomiting. In such cases, treatment methods depend on the size of the stone; if the stone is relatively small, it can often be passed naturally with increased water intake and conservative treatment. If the stone is large, it generally requires surgical removal. Hydronephrosis can also result from prolonged obstruction leading to impaired kidney function and uremia. In these situations, it's usually necessary to promptly relieve the urinary obstruction, maintain urethral patency, and, if the patient has elevated blood creatinine levels, employ dialysis or other methods to bring creatinine back to reasonable levels.

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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.