Hydronephrosis should see which department?

Written by Zhou Qi
Nephrology
Updated on September 17, 2024
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Hydronephrosis should be treated at a formal hospital's department of urology.

Hydronephrosis is due to some factor causing urinary tract obstruction, potentially seen in urological conditions such as stones, tumors, congenital abnormalities of the ureter, and other causes. These lead to the kidney producing urine that cannot be properly expelled. Dealing with this condition often requires intervention by the urology department, as hydronephrosis typically necessitates surgery.

In early stages, patients may need to adopt corresponding methods to address the specific causes. For instance, patients with stones might need extracorporeal shock wave lithotripsy, and open surgery might also be necessary; deformities of the ureter might need corrective surgery. These surgical treatments need to be performed in the urology department.

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Written by Zhou Qi
Nephrology
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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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Written by Zhou Qi
Nephrology
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symptoms of hydronephrosis infection

In cases of hydronephrosis, urinary tract infections are common, and these infections primarily manifest as pyelonephritis. The presence of fluid in the kidneys indicates that urine cannot be excreted smoothly, leading to an obstruction in the urinary tract. Therefore, bacteria can easily multiply in this area because normal urine, if it can be excreted smoothly, also serves to flush the urinary system, preventing the growth of bacteria. Thus, when fluid accumulates, pyelonephritis can easily occur, with the main symptoms being back pain and fever. If cystitis is also present, the patient will experience symptoms such as frequent urination, urgent urination, and painful urination. Hydronephrosis may be caused by issues such as urinary system stones or tumors, which can also lead to clinical symptoms like back pain and hematuria.

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Nephrology
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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.

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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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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.