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 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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Written by Zhou Qi
Nephrology
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Hydronephrosis should be seen by the Urology Department.

Hydronephrosis requires consultation at the urology department of a formal public hospital. Hydronephrosis refers to the situation where urine produced by the kidneys cannot be smoothly excreted. The primary reason is usually due to obstructions in the urinary tract below the kidneys, such as in the ureter or bladder. Obstructive factors primarily include stones, tumors, prostate enlargement in men, scarring or adhesions in the ureter, or inadequate ureteral motility, among others, often necessitating urologic intervention. These obstructive factors usually require surgical removal, such as using ultrasonic lithotripsy for stones or direct surgical intervention, thus necessitating a visit to urology.

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Written by Zhou Qi
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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Written by Chen Feng
Urology
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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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Written by Zhou Qi
Nephrology
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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.