Causes of hydronephrosis

Written by Zhou Qi

Nephrology

Updated on September 09, 2024

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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.

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Written by Zhou Qi

Nephrology

47sec

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Does hydronephrosis hurt a lot?

Hydronephrosis does not necessarily cause severe pain. If the hydronephrosis develops suddenly over a short period, it might cause intense pain, most commonly due to urinary system stones blocking the ureter, leading to hydronephrosis. At this time, the ureter may experience spasms, causing severe pain. However, if the hydronephrosis develops gradually, the patient's pain symptoms might not be pronounced. For example, insufficient motility of the ureter or some type of narrowing could lead to the accumulation of fluid. If this condition develops slowly and persists for a long time, the patient might not feel particularly uncomfortable, despite the hydronephrosis, and it may only be discovered incidentally during a physical examination.

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Written by Zhou Qi

Nephrology

1min

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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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Written by Li Liu Sheng

Nephrology

1min 12sec

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How is hydronephrosis detected?

The kidneys have a very strong compensatory ability. In the early stages of hydronephrosis, the amount of fluid may not be large, or the duration may not be long, and usually, the patient may have no symptoms. Hydronephrosis is often discovered during health examinations or through ultrasound or CT scans performed during hospital stays. Of course, if the hydronephrosis persists for too long and the volume is very large, the patient can gradually feel discomfort or a distended sensation in the lower back or upper abdomen. Moreover, if the hydronephrosis is caused by kidney stones, the patient often experiences severe back pain, and there might even be visible blood in the urine. Hydronephrosis can also lead to symptoms of urinary tract infections such as frequent urination, urgent urination, and painful urination. Prolonged hydronephrosis can lead to a decline in kidney function, resulting in symptoms like fatigue, loss of appetite, and poor overall health. Therefore, it is crucial for patients to undergo regular ultrasound examinations of the kidneys to detect hydronephrosis early.

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Written by Zhou Qi

Nephrology

58sec

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Is hydronephrosis with hematuria serious?

Whether hematuria in patients with hydronephrosis is serious cannot actually be determined by the amount of blood in the urine. It is important to identify the cause and assess kidney function, because hydronephrosis can lead to serious consequences, mainly kidney failure. If the hydronephrosis persists for a long time, it can compress the renal cortex and cause kidney shrinkage, leading to chronic kidney failure. The dangers of hematuria mainly include: first, it may cause significant bleeding, leading to anemia. Second, this type of hematuria could be caused by certain conditions, such as bleeding caused by a tumor in the urinary system, which is quite serious. Whereas bleeding caused by urinary tract infections or urinary system stones, in terms of the nature of the cause, is not considered very serious. However, significant bleeding can also lead to severe anemia and even shock, which would be more serious.

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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.