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Hydronephrosis

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Overview of Hydronephrosis

Hydronephrosis Meaning in Urdu

اس بیماری کی وجہ سے ایک یا دونوں گردے سوزش کا شکار ہو جاتے ہیں۔ جب پیشاب مکمل طور پر جسم سے خارج نہیں ہوتا اور گردوں میں جمع ہونے لگتا ہے تو پھر یہ سوزش کا شکار ہو تے ہیں۔ پیشاب کی نالی میں رکاوٹ بننے کی وجہ سے اس بات کے امکانات موجود ہوتے ہیں پیشاب مکمل طور پر جسم سے خارج نہ ہو۔ پیٹ کے نچلے حصے میں درد، پیشاب کرتے وقت تکلیف، متلی، قے اور بخار ایسی علامات جو اس بیماری کی وجہ سے لاحق ہو سکتی ہیں۔ عام طور پر خون کے اور پیشاب کے ٹیسٹ کی مدد سے اس کی تشخیص کی جاتی ہے۔

Hydronephrosis is a condition of the urinary tract in which swelling occurs in either one or both kidneys. This happens when the body is unable to remove all urine from the body. Hydronephrosis normally affects one kidney, but it can also affect both kidneys as well. 

Hydronephrosis is not a primary disease. But, rather it’s a secondary disease that occurs due to any underlying health condition. It is a structural disease and can result due to blockage in the tubes of the urinary tract that are responsible for draining the urine from the kidney's ureters. 

Prevalence 

Hydronephrosis is prevalent in about (0.15 to 0.67) of the population worldwide. The frequency of hydronephrosis is determined by the antenatal ultrasound in 1 case per 100 to 200 fetuses. The ratio of male to female is 2:1. About 1 out of 100 babies suffer from hydronephrosis. 

Signs and Symptoms of Hydronephrosis

The hydronephrosis symptoms normally depend on the cause of hydronephrosis. The symptoms of hydronephrosis include:

  • Nausea
  • Vomiting
  • Intense or sudden pain in the back or at the side
  • Blood in the urine
  • Frequent urination
  • Weakness or malaise
  • Painful urination
  • Fever due to UTIs
  • Failure to nourish properly, in infants

Types of Hydronephrosis

There are two types of hydronephrosis such as acute hydronephrosis and chronic hydronephrosis. These types are further divided into two types based on the kidney affected such as:

  1. Unilateral Hydronephrosis

When one kidney is affected due to hydronephrosis, it is called unilateral hydronephrosis.  

  1. Bilateral Hydronephrosis

When both kidneys of our body are affected, it is called bilateral hydronephrosis.

Both these hydronephrosis types can affect the function of the kidney.

Causes of Hydronephrosis

Hydronephrosis is caused by various underlying health conditions and factors. Hydronephrosis causes include and are not limited to the following illnesses or risk factors:

In women, hydronephrosis can be due to:

  • Pregnancy
  • Uterine Prolapse
  • Cystocele (fallen bladder)
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Risk Factors of Hydronephrosis

The common hydronephrosis risk is similar to that of the causes of hydronephrosis such as kidney stones, tumor formation (prostate or cervical cancer), external compression from abdominal or pelvic masses, diabetes mellitus, urinary tract infections, congenital anomalies, neurogenic bladder, VUR, posterior urethral valves, and ureteropelvic junction obstruction.

Health Complications Due to Hydronephrosis

One of the most common health complications of hydronephrosis is the development of urinary tract infections (UTIs). The UTIs can further lead to high fever and kidney infection. This can be caused by the spreading of bacteria from the bladder to the kidney and then invading the kidneys.

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Prevention

Hydronephrosis is majorly caused by underlying health issues that’s why prevention depends upon avoiding and treating the major cause. For example, the chance of a person suffering from a kidney stone is reduced by getting it treated.

You need to seek an expert urologist or pediatric urologist in the case of children for consultation and treatment when you observe any concerning signs and symptoms.

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Diagnosis

Your doctor will first inquire about your signs and symptoms, medical history or do a physical examination. 

  1. Physical Examination

In a physical examination, the doctor will check the swelling or tenderness near the area of the kidneys or bladder. 

The doctor will also inquire about your family medical history along with checking if there is any pelvic swelling. 

In the case of men, the doctor will do a rectal examination to check if the prostate is enlarged or not. While for women, a pelvic examination may be done to check if there is any problem with the ovaries or uterus. 

  1. Urine Examination

A complete urine examination along with a urine culture test will be done to check if there is blood, crystal, stone, or any signs of infection.

  1. Blood Tests

A complete blood count test may be recommended by the doctor to check if there is any infection or not. Other tests for kidney health such as renal function tests, estimated GFR, or blood urea nitrogen (BUN) tests may also be done. 

  1. Imaging Tests

Ultrasound, CT Scan, or MRI test may also be done for the diagnosis of hydronephrosis. 

Treatment of Hydronephrosis | When to Consult a Doctor

The main aim of the hydronephrosis treatment is to restore the normal flow of urine from the kidney. This thereby helps to decrease the swelling and pressure that is caused by the urine backup. 

The hydronephrosis treatment varies from patient to patient depending upon the type, cause, and severity of the case of the patient’s condition. 

If the hydronephrosis is sudden or acute, in this case, a nephrostomy tube is inserted. It is a soft tube or stent. It is inserted via the skin into the kidney to drain the excess urine flow.  A ureteral stent which is a soft plastic tube may also be placed between the bladder or kidney by the urologist during the process of cystoscopy to drain the excess fluid.

If however, the hydronephrosis is due to kidney stones or ureters, the following treatment options are opted:

  1. Shock Wave Lithotripsy

It is one of the most common methods for kidney stone treatment. In this procedure, high-energy shock waves are emitted by the machine to break the stones into small pieces or dust that can be passed out easily by the doctor. 

  1. Ureteroscopy

In this, a special instrument is placed in the ureter which helps your doctor in breaking and removal of the stones. This method has commonly opted when the stones are in the lower half of the ureter or bladder.

Ureteroscopy can also be used in combination with other techniques such as electrohydraulic lithotripsy or pulsed dye laser to break the stones. This is normally a method of choice in treating pregnant patients, or patients who suffer from severe obesity or blood clotting disorders.

  1. Surgery

When it is difficult to remove kidney stones by the aforementioned methods, the surgical method is used to treat the patient. A patient might also need to undergo surgery in case of any blockage or tumor. 

Medication for the Hydronephrosis Treatment

There are mainly two types of medications that are used for hydronephrosis treatment which are:

  1. Antibiotics

Antibiotics are given to patients to treat and prevent urinary tract infections to treat hydronephrosis.

  1. Analgesics

These medications are given to relieve the pain due to hydronephrosis.

(Note: Take medication only after the doctor’s prescription)

In case you have any concerning signs and symptoms you need to reach out to a certified urologist to get yourself treated.

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