What Is Hydronephrosis?

Hydronephrosis is a painful swelling of one or both kidneys, due to urinary buildup. This condition can come on suddenly or gradually, and signal blockage or dysfunction anywhere in the urinary system, including the kidneys, ureters, bladder, or urethra. Kidneys are responsible for removing toxins from the bloodstream and passing them from the body as urine. Their inability to do so efficiently can generate a number of medical issues, the most serious of which is renal failure. If a single kidney is affected, the condition is called unilateral hydronephrosis. If both are involved, it is called bilateral hydronephrosis.

Hydronephrosis can strike at any age but is relatively common among infants. It is estimated that about one out of every 500 babies may suffer from a form a hydronephrosis, based on a congenital defect in the urinary tract. If you or a loved one are experiencing the symptoms of hydronephrosis, make an appointment with a member of the Baptist Health urology team for consultation and treatment.

What Are the Symptoms of Hydronephrosis?

The symptoms of hydronephrosis include:

• Sudden or chronic pain in the lower back or side
• A constant desire to go to the bathroom
• Painful urination
• Bloody urine
• Nausea and vomiting
• Fever and chills
• Fatigue or exhaustion

One common side effect of hydronephrosis is urinary tract infections or UTIs. The symptoms for UTIs are very similar to those listed above.

What Causes Hydronephrosis?

Hydronephrosis can have several different sources. These include:

• Cancers of the bladder, uterus, prostate gland, or other organs associated with or located near the urinary tract
• Kidney stones
• Blood clots in the kidney or uterus
• Diabetes-related conditions of the muscles or nerves
• Narrowed ureters, which pass urine from the kidneys to the bladder
• A narrowed urethra, which passes urine from the bladder out of the body
• Ureterocele, a protrusion of the ureter into the bladder
• Vesicoureteral reflux, a reverse flow of urine from bladder to kidney
• An enlarged prostate gland in men

At-risk groups for hydronephrosis are infants, men over age 50 (due to prostate enlargement), pregnant women, sexually active women (due to an increased likelihood of urinary tract infections), and persons with a history of kidney stones.

How Is Hydronephrosis Diagnosed?

The diagnosis of hydronephrosis typically requires one or more of the following steps:

• Physical examination: Your physician will ask about your symptoms, record your family medical history, and inspect your kidney and bladder areas for swelling or tenderness. Women might undergo a pelvic exam for issues of the uterus or ovaries; men, a rectal exam for prostate enlargement.
• Urine tests: A urine sample will be analyzed for evidence of kidney-stone fragments, blood, or infectious bacteria. 
• Blood tests: Blood tests can provide evidence of a kidney infection. Kidney-function tests will focus on creatine and blood urea nitrogen levels, as well as the estimated glomerular filtration rate, or eGFR, which approximates the rate of fluid flow through the kidneys. 
• Imaging: CAT scan, MRI, or ultrasound images of your urinary tract may provide additional insight into your condition.

How Is Hydronephrosis Treated?

The immediate goal in treating hydronephrosis is to relieve pressure and pain by increasing the flow of urine out of the kidneys. This can be done by means of a stent inserted into the kidney through the skin. Other potential remedies for severe cases of hydronephrosis are:

• Surgery: Your physician may select surgery as the best method for opening the constrictions, or removing the tumors, blockages, or stones, that are causing your hydronephrosis. 
• Lithotripsy: If kidney stones are the source of your condition, lithotripsy is a proven means of treating them. Your body is subjected to high-energy vibrations that break the stones up into small pieces, so they can more easily pass through the urinary tract. 
• Ureteroscopy: Ureteroscopy is another method for treating kidney stones. A narrow tube is placed inside the urethra, with surgical instruments for fragmenting and removing obstructions. Targeted stones have typically moved from the kidneys into the ureters or bladder. 

These treatments are typically combined with pain medications and antibiotics. 

Early treatment of hydronephrosis is frequently successful. 

Learn More About Hydronephrosis from Baptist Health

For more information about hydronephrosis diagnosis and treatment, schedule an appointment with our physicians.