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Hydronephrosis is a swelling of the kidney due to the inability of the bladder to release urine, associated with swelling of the ureter connecting the kidneys and bladder.
This condition can occur due to problems situated at any level between the kidneys and bladder, as well as around the urethra. Depending on the cause, hydronephrosis may comprise one kidney or both involved.
The increased pressure caused by disease potentially impair kidney function, unless there is a quick intervention. The symptoms of hydronephrosis depend on whether we are dealing with the state of acute illness or one that occurs gradually (chronic).
The causes of hydronephrosis
There are many reasons for the occurrence of disease, and they are divided, depending on the location of the edema, and whether the reasons for the problem is an internal (within a urine collection system) or external (outside the collective).
To the intrinsic causes of hydronephrosis include:
- kidney stones – the most common cause of unilateral hydronephrosis, which contributes to the obstruction of the ureter, with the result that the kidneys swell and can not release the urine,
- blood clots,
- stenosis or scarring.
- cancer of the bladder,
- bladder stones,
- herniation of the bladder,
- bladder neck contracture.
In the urethra:
- inability to empty the bladder (urinary retention) for any reason, may cause bilateral hydronephrosis,
- urethral stricture,
- urethral cancer.
To external causes of hydronephrosis include, in turn, can be:
- tumors, cancer, and other changes that compress the ureters and prevent the flow of urine; most frequently are lymphomas or sarcomas, located in the retroperitoneum, or intestinal area,
- retroperitoneal fibrosis,
- team ovarian veins,
- cervical cancer,
- prostate cancer,
- pelvic prolapse,
- scars as a result of radiotherapy.
In the urethra:
- prostatic hypertrophy or swelling,
- prostate cancer.
In the bladder:
- neurogenic bladder or the inability to the proper functioning of the bladder, which is a result of nerve damage; It may be a consequence of tumors in the brain, spinal cord injuries, multiple sclerosis, diabetes, and others.
The symptoms of hydronephrosis
The symptoms of hydronephrosis depend on the cause. At acute hydronephrosis, may appear in the form of renal colic kidney stones and back pain is radiating to the groin, nausea, vomiting or excessive sweating. The intensity of colic can cause extremely severe pain, and blood in the urine.
Chronic hydronephrosis is developing gradually over extended periods of time without showing symptoms. Tumors or other changes in the pelvis can grow unnoticed, while the patient may suffer from symptoms of kidney failure. The symptoms of the disease may, therefore, include general weakness, chest pain, malaise, shortness of breath, leg swelling, vomiting, nausea. Often with hydronephrosis appears electrolyte abnormalities because the kidneys are unable to regulate the levels of sodium, potassium, and calcium, and with them appear abnormal heart rhythm or muscle cramps.
If there is a sudden pain, blood appears in the urine or high fever, be sure to seek medical attention.
Diagnosis of and treatment of hydronephrosis
Physical examination is the first step in diagnosing of hydronephrosis, enabling the assessment of the possible swelling of the kidneys. Then laboratory tests are performed as:
- urine analysis for the presence of blood, infection and abnormal cells
- complete blood count may reveal anemia or potential infection,
- analysis of electrolytes allows assessing whether we are not dealing with a chronic form of hydronephrosis,
- other blood tests such as those for the presence of urea nitrogen or creatinine,
- and imaging tests – computed tomography, ultrasound, x-ray.
The goal of treatment of disease is to restart the free flow of urine from the kidney, reducing swelling and pressure which rises in the vicinity of the organ and limiting their activity.
At first, it is important to minimize the symptoms of pain and prevention of urinary tract infections, and sometimes surgery is required.
The most common treatment of hydronephrosis comprises treatment of co-existing kidney stone, lumps, infections and the like so that treatment can be very different.
If left untreated, the disease can increase the pressure in the kidneys, reduce their ability to filter the blood and remove waste products, as well as the regulation of electrolytes in the body. It may also contribute to the formation of infection, loss of kidney function, or even death.
Quick response, can restore full functionality of the organ. In the case of chronic hydronephrosis, however, can lead to permanent kidney damage.