Hydronephrosis is a disease characterized by progressive enlargement of the renal pelvis and calyces due to obstruction of urine outflow from the kidney. An increase in urine pressure in the kidney with hydronephrosis leads to impaired blood circulation in the organ, atrophy of the parenchyma, and a steady decrease in kidney function.
Distinguish between congenital and acquired hydronephrosis. Congenital hydronephrosis is caused by the presence of an anomaly in the development of the pelvis, ureter, or kidney and develops against the background of the following diseases:
- urolithiasis disease
- inflammatory changes in the urinary system
- traumatic narrowing of the urinary tract (arising after injury)
- tumors of the urinary tract
- tumors of the cervix
- traumatic spinal cord injury
The main manifestation of the initial stage of hydronephrosis is a pain in the lumbar region in the form of attacks of renal colic. Attacks of pain in hydronephrosis can be accompanied by nausea, vomiting, bloating, and increased blood pressure. With the development of infection, an increase in body temperature occurs and a picture of acute pyelonephritis develops.
In the later stages of hydronephrosis, pain is usually absent or mild. At the same time, the size of the hydronephrotic kidney increases, and it becomes easily accessible for palpation.
Diagnosis of hydronephrosis
Diagnosis of hydronephrosis includes:
- a kidney ultrasound (renal ultrasound) - there is an expansion of the pyelocaliceal system and atrophy of the parenchyma
- excretory urography, which allows to identify the expansion of the pelvicellular system, as well as indirectly assess the function of the kidney
Surgical treatment of hydronephrosis is aimed at removing the obstacle to the normal outflow of urine from the kidney. Moreover, the earlier the plastic surgery was performed, the more chances of preserving kidney function.
In the case of the development of signs of renal failure, it is possible to carry out the operation in two stages - the imposition of a nephrostomy (drainage of the kidney until the patient's condition is normalized), followed by the plastic surgery of the ureter and pelvis.
With advanced forms of hydronephrosis, removal of the kidney is indicated to avoid the development of infectious complications.