How is hydronephrosis caused?

Written by Zhou Qi
Nephrology
Updated on September 25, 2024
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The causes of hydronephrosis can be divided into congenital, acquired, and external factors. Among these, acquired causes are the most common, primarily referring to obstructions in the urinary tract, such as stones that block the ureter, leading to hydronephrosis, inflammation, or ischemic damage. Scarring of the ureter can also result in hydronephrosis. Tumors or polyps in the renal pelvis and ureter may also cause obstructions leading to fluid accumulation. External causes mainly include diseases of retroperitoneal organs, such as abscesses, bleeding, tumors in the retroperitoneum, and pelvic tumors, like rectal cancer. Congenital causes mainly involve intrinsic narrowing of the ureter, ectopic vessels causing compression, and high insertion of the ureter, which are less common.

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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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Written by Zhou Qi
Nephrology
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How is hydronephrosis caused?

The causes of hydronephrosis can be divided into congenital, acquired, and external factors. Among these, acquired causes are the most common, primarily referring to obstructions in the urinary tract, such as stones that block the ureter, leading to hydronephrosis, inflammation, or ischemic damage. Scarring of the ureter can also result in hydronephrosis. Tumors or polyps in the renal pelvis and ureter may also cause obstructions leading to fluid accumulation. External causes mainly include diseases of retroperitoneal organs, such as abscesses, bleeding, tumors in the retroperitoneum, and pelvic tumors, like rectal cancer. Congenital causes mainly involve intrinsic narrowing of the ureter, ectopic vessels causing compression, and high insertion of the ureter, which are less common.

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Written by Zhou Qi
Nephrology
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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.

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Nephrology
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Will hydronephrosis cause facial swelling?

In cases of hydronephrosis, it is not certain whether facial swelling will occur. Since the human body has two kidneys, the kidneys have strong compensatory capabilities. Even if one kidney is completely damaged, if the other kidney remains healthy, the remaining kidney can still perform the function of two kidneys. It can ensure sufficient excretion of water and metabolic waste. When water is sufficiently excreted, swelling should not occur. However, if both kidneys are affected by hydronephrosis, or if the opposite kidney also has problems, then the ability of the kidneys to excrete water may decrease. With both kidneys having issues, it can lead to poor and insufficient water excretion, consequently causing swelling, such as bilateral eyelids, facial areas, and both ankles.

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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.