Hydronephrosis is the dilation or swelling of kidneys because of a blockage that stops urine from flowing out of the body.
Hydronephrosis can be cured, depending on the cause. Complications include urinary infections, high blood pressure, kidney failure, and dehydration.
The cause is a blockage of any part of the urinary tract. In children, the blockage is often due to abnormalities such as narrowing or pinching of the urethra. The urethra is the tube taking urine from the bladder to outside the body. Also narrowing at the opening of the ureters, the tubes carrying urine from the kidneys to the bladder, can cause a blockage.
In adults, causes often include kidney stones, enlarged prostate gland, and prostate cancer. Other causes are cancers of the bladder, uterus, ovary, and colon that spread to other parts of the body and block the flow of urine.
Symptoms depend on the cause. For example, people with kidney stones may have blood in the urine and severe pain in the side (flank) that travels to the groin. Men with prostate cancer or an enlarged prostate may have problems urinating, need to urinate at night, and be unable to completely empty the bladder. People with colon cancer may see blood in the stools (bowel movements) or change in bowel movements.
In addition to the physical exam, the health care provider will make a diagnosis by using blood and urine tests to check the kidney function and special x-rays such as ultrasonography or computed tomography (CT).
Treatment depends on the cause. The goal is to get rid of the blockage. For a sudden obstruction, as in men with enlarged prostate glands, a catheter is put through the urethra into the bladder. The catheter gives temporary and instant relief of symptoms until more complete therapy, such as medicine or surgery, can be given.
People with kidney stones are usually treated by a urologist (a surgeon specializing in diseases of the genital and urinary tract) with medications for pain control and increasing fluid intake. Shock wave treatment (lithotripsy) or surgery can be done to remove the stones if they are too large to pass on their own.
The kidney can return to normal, depending on how long the blockage has been there; whether problems such as infections, stones, or other causes of the blockage are also present; and how severe the blockage is.
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