Hydronephrosis is a condition defined by an abnormal dilation of the renal pelvis and calyces of one or both of the kidneys caused by an obstruction. Even though partial obstruction may not instantly produce signs and symptoms, the pressure that builds up behind the obstruction can result in serious symptomatic renal dysfunction. When the partial obstruction occurs, the bladder acts like a buffer and dilates, causing a delay to hydronephrosis. Almost any kind of uropathy can and normally does result in a form of hydronephrosis. This condition occurs in one out of every one hundred people.
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Hydronephrosis is caused by a backward pressure on the kidneys when the urine flow is obstructed in the genitourinary tract. Urine flow can be obstructed by kidney stones, blood clots, urethral strictures, congenital abnormalities, abnormal tumours, neurogenic bladder and benign prostatic hyperplasia.
Symptoms vary depending on the cause of the obstruction. They extend from mild pain and slightly decreased urinary flow to excruciating and colicky renal pain. Other symptoms include dull flank pain that travels to the groin; gross urinary abnormalities, including hematuria, alternating oliguria and pyuria; or complete anuria and dysuria. Other symptoms include nausea, vomiting, pain during urination, abdominal fullness, dribbling or hesitancy when urinating. his condition can be diagnosed with urography, isotope renography or a renal ultrasound.
The most common complication is kidney infection, usually as a result of bacteria spreading from the bladder. Kidney damage, renal enlargement and kidney failure can also be complications of hydronephrosis. These complications vary depending on the cause of the obstruction to the genitourinary tract. There are two types of hydronephrosis. Bilateral hydronephrosis is when the obstruction is in the urethra or bladder. Unilateral hydronephrosis occurs when the obstruction is in a ureter.
The goals when treating hydronephrosis is to remove the obstruction and prevent infection by removing the cause surgically. If renal function has already been affected, further therapy, including diet restrictions, may be necessary. Treatment may require a temporary or permanent nephrostomy tube inserted to regularly drain the kidneys. Recurring infections call for an antibiotic treatment.
Prevention methods include a dietary change to prevent obstructions such as kidney stones. These dietary changes include lowering the intake of sugary and/or carbonated drinks; lowering the intake of sodium, protein and potassium; and drinking more clear fluids, specifically water. Complications that arise with hydronephrosis can result in serious consequences if left untreated.
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