Hydronephrosis Treatment in India

Overview of Hydronephrosis

Hydronephrosis, also known as upper urinary tract dilation, occurs when urine cannot flow properly from the kidney to the bladder, causing one or both kidneys to swell. It may develop suddenly or over time and can be partial or complete, affecting one kidney (unilateral) or both kidneys (bilateral). The severity can range from mild to severe swelling. Without timely treatment, hydronephrosis may reduce kidney function or lead to kidney failure, but early management can help prevent long-term complications.

Hydronephrosis can affect people of any age and occurs in about 1 in 100 adults during their lifetime. In infants, it is often caused by a blockage that develops before birth (antenatal hydronephrosis). This condition affects up to 1% of pregnancies and usually improves on its own before delivery.

Causes of Hydronephrosis

Hydronephrosis can develop due to several conditions, including:

Birth-related conditions: Some babies are born with a partial blockage, such as ureteropelvic junction obstruction, where the kidney connects to the ureter. Others may have an abnormal ureter that allows urine to flow backwards from the bladder into the kidney, a condition called vesicoureteral reflux
Kidney stones: Hard deposits of minerals and salts that form in the kidneys can block urine flow
Enlarged prostate: An enlarged prostate can prevent the bladder from emptying fully, causing urine to back up into the kidneys
Blocked or narrowed ureter: Injury, scarring after surgery or radiation treatment may cause the ureter to become narrowed and restrict urine flow
Urinary tract infection (UTI): Infections can cause inflammation in the urinary system, including the kidneys
Pregnancy: Hormonal changes and pressure from the growing baby can enlarge the kidney drainage system. This usually improves after childbirth
Cancer: Tumours from cancers such as bladder, cervical, colon, or prostate cancer can block parts of the urinary tract and cause hydronephrosis.

Signs and Symptoms

Symptoms of hydronephrosis may include:

Pain in the lower back, side or abdomen
Increased need to urinate
Difficulty passing urine
Cloudy urine
Blood in the urine
Fever, chills, or feeling hot and shivery

Risk Factors

In adults aged 20–60: Higher risk may be associated with being assigned female at birth due to conditions affecting the uterus, such as pregnancy, or the ovaries, including cysts, infections or cancer
In adults over 60: Risk factors may include an enlarged prostate or urinary tract blockage caused by cancer

Diagnosis

In Adults

Diagnosis begins with a healthcare provider reviewing your symptoms and medical history and performing a physical examination. You may be referred to a urologist, a specialist who diagnoses and treats urinary system conditions.

Tests used to diagnose hydronephrosis may include:

Blood tests: Check kidney function and how well the kidneys are working
Urine tests: Help identify signs of infection or kidney stones that may be causing blockage
Ultrasound: Provides images of the kidneys, bladder and urinary tract to detect possible problems
Computed tomography (CT) urogram: An X-ray test using contrast dye to create images of the urinary tract before and after urination

Additional imaging tests, such as a magnetic resonance imaging (MRI), may be recommended. During pregnancy, hydronephrosis in unborn babies is often detected through routine ultrasound scans.

In Babies

Healthcare professionals diagnose hydronephrosis in newborns using medical history, physical examination and imaging tests.

Medical history: Prenatal ultrasound results and other pregnancy-related tests help determine the appropriate evaluations and treatments needed after birth
Physical examination: The healthcare provider checks for abdominal lumps or swelling that may indicate an enlarged kidney or bladder. They also look for signs of other birth abnormalities.
Imaging tests: Urinary tract imaging may be used to identify hydronephrosis and its cause, including:
Ultrasound: Uses sound waves to examine the kidneys and urinary tract
Voiding cystourethrogram (VCUG): Uses X-rays to evaluate urine flow through the bladder and urethra
Radionuclide scan: Produces images of the urinary system by tracking a small amount of radioactive material as it moves through the urinary tract

Treatment

The main goal of treatment is to restore normal urine flow from the kidney and reduce swelling and pressure. Treatment focuses on addressing the underlying cause of the condition. Mild cases may improve without treatment, while some patients may be monitored through a “wait and see” approach. In other cases, surgery or other treatments may be recommended based on the condition.

For sudden hydronephrosis caused by a blockage:

A nephrostomy tube may be placed through the skin into the kidney to drain excess urine
A ureteral stent may be inserted to keep the ureters open and allow urine to flow normally

If kidney or ureter stones are causing the blockage, treatment options may include:

Shock wave lithotripsy: Uses high-energy waves to break kidney stones into smaller pieces that can pass through the urinary system
Ureteroscopy: A thin tube is inserted through the urethra to locate, break and remove stones
Surgery: May be needed for very large stones or blockages caused by tumours, scar tissue or other conditions

If hydronephrosis is caused by a UTI or narrowing related to infection, antibiotics may be prescribed to treat the infection.

Recovery

Hydronephrosis can become serious if it is not treated promptly. However, most cases are mild to moderate and do not lead to major health complications.

Prevention

Preventing hydronephrosis involves avoiding or treating the underlying causes early. Knowing the factors that increase your risk can also help with prevention.

Conditions that may increase the risk of hydronephrosis include:

Kidney stones
A history of urinary tract cancers
Previous urinary tract surgeries
Past UTIs
Blood clots
Enlarged prostate
Pregnancy, as the growing uterus may put pressure on the urinary system

Complications of Hydronephrosis

When hydronephrosis is diagnosed and treated early, it usually does not lead to long-term complications, and most people recover well. However, untreated or severe cases can cause kidney damage and may progress to kidney failure. In such cases, treatments like dialysis or a kidney transplant may be required.

When should I See my Healthcare Provider?

Contact your healthcare provider if you experience symptoms such as:

Sudden or severe pain in your side or back
Vomiting
Changes in urination, including increased or decreased urine output, painful urination, or blood in the urine
Fever higher than 100.5°F (38°C)