Best Hydronephrosis Treatment in Delhi, India

Hydronephrosis occurs when either one or both kidneys become swollen due to the inability of urine to drain effectively from the kidneys to the urinary bladder. It is not a primary disease but a secondary condition that occurs because of some underlying pathology. 

It can involve either one or both kidneys. If only one kidney is affected, it is termed unilateral hydronephrosis; if both kidneys are involved, it is termed bilateral hydronephrosis. Suppose there is any issue in the urinary tract, from the kidneys to the ureters, the bladder, or the urethra. In that case, it results in impaired emptying of the urinary bladder, thereby accumulating fluids and leading to pressure in the kidneys.

Hydronephrosis can occur at any age, including children and adults. In children, it may be due to anatomic abnormalities, whereas in adults, it can be due to kidney stones. Hydronephrosis may result in altered kidney function. It requires medical care and attention; otherwise, it can also result in kidney failure.

Symptoms of Hydronephrosis 

In hydronephrosis, urine tends to accumulate in the kidneys for an extended period resulting in the enlargement of the kidneys. If this condition is left untreated for a more extended period, the kidneys will press on surrounding organs, and the increased pressure will cause the impaired function of kidneys.

The following are the symptoms of hydronephrosis:

• Pain during urination
• Incomplete emptying of the bladder
• Fever
• Nausea
• Vomiting
• Pain in the abdomen
• Weakness
• Fatigue
• Blood in the urine
• Backache

Causes of Hydronephrosis 

Hydronephrosis is caused by internal and external factors affecting the kidney and the urinary system. The following are the most commonly seen conditions that cause hydronephrosis:

• Enteroceles are characterized by the swelling of one of the ureters at the bottom.
• Urinary retention, due to the inability to empty the urinary bladder.
• Kidney stones, which get trapped either in the kidney or urinary tract and may vary in size.
• The presence of blood clots in the kidney or ureter.
• Benign Prostatic Hyperplasia, which is characterized by an enlargement of the prostate gland, leading to increased pressure on the urethra.
• Vesicoureteral reflux is characterized by a backward flow of urine from the bladder to the kidneys.
• Narrowing of the urinary tract due to infection, injury, surgery, or congenital disabilities
• Nerve problems in the body affecting the kidneys or ureters
• Certain cancers can affect the urinary system because if the tumor is pressing against certain parts of the urinary system, it will obstruct urine flow from the kidneys. Cancer can spread to the kidneys, prostrate, and even the bladder
• Pregnancy causes the womb to block the tubes responsible for connecting the bladder and kidneys.
• A prolapsed uterus is a condition characterized by the uterus slipping out of its normal position.
• Cystoceles are characterized by a weakening of the wall between the bladder and the vagina, resulting in the bladder dropping into the vagina.

Diagnosis of Hydronephrosis 

The following tests are performed to diagnose this condition:

• Physical Examination: The doctor evaluates the area around the kidneys and bladder for tenderness and swelling. For men, a rectal examination is also carried out to rule out prostate enlargement, whereas, for women, a pelvic examination is carried out to determine the problems with the uterus and ovaries.
• Renal Ultrasound Scan: It uses sound waves to access various organs inside the body, including the kidneys and urinary tract. It helps to determine the extent of swelling as well as the area of blockage.
• Blood tests: Comprise Complete Blood Count (CBC) to determine any infection in the kidneys and Kidney Function Test (KFT) to ascertain the proper functioning of the kidneys.
• Imaging Procedures: May comprise a CT (Computed Tomography) Scan and a Magnetic Resonance Imaging (MRI) scan.
• Renal Mercaptoacetyltriglycine (MAG3) Scan is a diagnostic test performed to visualize the kidneys and monitor their functioning.

Treatment of Hydronephrosis 

The treatment of hydronephrosis aims to restore the flow of urine from the kidneys, decrease the swelling around the kidney and relieve the pressure caused by the accumulation of urine. The treatment includes the following:

• Insertion of nephrostomy tube through the skin to the kidneys to drain excessive urine.
• Antibiotic therapy is given to lower the risk of urinary tract infections
• Shockwave lithotripsy is given to treat kidney stones. Shock waves are emitted from a machine, which helps break up the stones into a powdered form or even smaller fragments so they can be flushed out of the body.
• Ureteroscopy is another procedure performed in the urethra to break up and remove stones. This procedure occurs when the stones are present in the lower half of the ureters or the bladder. It can be performed alone or sometimes with other techniques, such as electro-hydraulic lithotripsy, to break the stones.
• Surgical removal of stones.

Complications of Hydronephrosis

The following are the complications of hydronephrosis:

• Urinary tract infection
• Kidney infection
• Post-obstruction dieresis
• Kidney failure

Early treatment is very beneficial in determining the outlook of this condition. For cases requiring surgery, the recovery is almost complete and normal. However, for the kidneys to return to normal functioning, it is essential to eliminate obstruction in the kidneys.

Review 

Reviewed By Dr. Gaurav Garg (Uro), Senior Consultant - Urology/Andrology, Robotic Surgery on 12 June 2024.