Materiały źródłowe

• #1 Hydronephrosis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/hydronephrosis?embed_domain=hackmd.io%2525252F%25252540yIPUAFeCSL2JsU8smR5nJQ%2525252Fbnjhjgjghjghjghfavicon.icoradiopaedia-icon-144.png&lang=gb

  Hydronephrosis (plural: hydronephroses) is defined as dilatation of the urinary collecting system of the kidney (the calyces, the infundibula, and the pelvis). […] Following the identification of hydronephrosis, appropriate further investigations must be undertaken to establish an underlying cause, such as urolithiasis, pelviureteric junction obstruction, malignancy such as cervical cancer, and retroperitoneal fibrosis. […] Ultrasound imaging of hydronephrosis will demonstrate a dilated pelvicalcyceal system. The severity is often classified into mild, moderate or severe hydronephrosis. […] CT will readily show hydronephrosis, and can also help identify the cause. […] A nuclear medicine diuretic renogram may be performed to assess for obstruction of urine and differentiate from other causes such as an extra-renal pelvis or parapelvic cysts. […] The radiologist may also play a part in procedures to treat the harmful effects of uncorrected hydronephrosis on renal function, such as placement of a percutaneous nephrostomy tube or antegrade ureteric stent insertion.

• #2 Hydronephrosis and Hydroureter: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/436259-overview

  Hydronephrosis and hydroureter are common clinical conditions encountered not only by urologists but also by emergency medicine and primary care physicians. Hydronephrosis is defined as distention of the renal calyces and pelvis with urine as a result of obstruction of the outflow of urine distal to the renal pelvis. Analogously, hydroureter is defined as a dilation of the ureter. […] The presence of hydronephrosis or hydroureter can be physiologic or pathologic. It may be acute or chronic, unilateral or bilateral. It can be secondary to obstruction of the urinary tract, but it can also be present even without obstruction. […] Obstructive uropathy refers to the functional or anatomic obstruction of urinary flow at any level of the urinary tract. Obstructive nephropathy is present when the obstruction causes functional or anatomic renal damage. Rarely, obstructive nephropathy may occur in the absence of hydronephrosis.

• #3 Hydronephrosis and Hydroureter – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK563217/

  Hydronephrosis and hydroureter result from obstruction of urine flow in the urinary system at the renal pelvis and ureter level, respectively. […] Both conditions should be promptly diagnosed and treated to prevent severe renal dysfunction. […] This activity reviews the etiology, epidemiology, and diagnosis of hydroureteronephrosis and highlights the role of prompt management for timely prevention of renal dysfunction. […] Hydronephrosis is defined as dilatation and distension of the renal collecting system of one or both kidneys due to obstruction of urine outflow distal to the renal pelvis (i.e., ureter, urinary bladder, and urethra). […] Hydronephrosis and hydroureter can present independently or together. […] The presentation can be acute or chronic, physiologic (very common in pregnant females) or pathologic, unilateral, or bilateral.

• #4 Hydronephrosis | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/hydronephrosis-urinary-tract-dilation

  When urine cant drain properly from your childs kidney to their bladder, their kidney can become enlarged (dilated) with that extra urine. This is called hydronephrosis, or you might also hear your doctor call it, urinary tract dilation. […] Hydronephrosis can range from mild to severe, depending on the cause of the dilation. Often children who have hydronephrosis have it from the time of birth. […] Prenatal hydronephrosis (which may also be called antenatal hydronephrosis, or fetal urinary tract dilation) is one of the most common fetal anomalies diagnosed before birth. […] Due to the increased use of prenatal ultrasound, were able to detect hydronephrosis sooner than we were able to in the past. Hydronephrosis is now found in 1 out of 100 pregnancies. […] If hydronephrosis is detected, youll have more follow-up ultrasounds to monitor amniotic fluid levels, the amount of dilation, if the dilation is in one of your childs kidneys or both, if their ureters are dilated, and if there is normal filling and emptying of their bladder.

• #5 Frontiers | Prenatal Diagnosis and Findings in Ureteropelvic Junction Type Hydronephrosis

  https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2020.00492/full

  Prenatal Diagnosis and Findings in Ureteropelvic Junction Type Hydronephrosis […] The widespread use of obstetric ultrasonography has increased the detection rate of antenatal hydronephrosis. Although most cases of antenatal hydronephrosis are transient, one third persists and becomes clinically important. Ultrasound has made differential diagnosis possible to some extent. Ureteropelvic junction type hydronephrosis (UPJHN) is one of the most common cause of persistent fetal hydronephrosis and occurs three times more in male fetuses. It is usually sporadic and unilateral. However, when bilateral kidneys are involved and presents with severe hydronephrosis, the prognosis may be poor. Typical ultrasound findings of UPJHN is hydronephrosis without hydroureter. The size and appearance of the fetal bladder is usually normal without thickening of the bladder wall. Several grading systems are developed and increasingly being used to define the severity of prenatal hydronephrosis and provides much more information about prediction of postnatal renal prognosis. If fetal urinary tract dilation is detected; laterality, severity of hydronephrosis, echogenicity of the kidneys, presence of ureter dilation should be assessed. Bladder volume and emptying, sex of the fetus, amniotic fluid volume, and presence of associated malformations should be evaluated. Particularly the ultrasonographic signs of renal dysplasia, such as increased renal parenchymal echogenicity, thinning of the renal cortex, the presence of cortical cysts, and co-existing oligohydramnios should be noticed. Unfortunately, there is no reliable predictor of renal function in UPJHN cases. Unilateral hydronephrosis cases suggesting UPJHN are mostly followed up conservatively. However, the cases with bilateral involvement are still difficult to manage. Timing of delivery is also controversial. […]

• #6 Hydronephrosis: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/unilateral-hydronephrosis

  Hydronephrosis typically occurs when a kidney swells due to urine failing to drain properly from the kidney to the bladder. […] Hydronephrosis is said to affect about 1 in every 100 babies. […] Getting a diagnosis as early as possible is extremely important. Your kidneys could be permanently damaged if your condition is left untreated for too long. […] Your doctor may also want to perform a renal ultrasound or CT scan to get a closer look at the extent of the swelling and to possibly locate the area of the blockage. […] Both of these procedures let your doctor view an image of the inside of your body, but the renal ultrasound is generally considered the gold standard for the diagnosis of hydronephrosis. […] Treatment for hydronephrosis primarily focuses on getting rid of whatever is blocking the flow of urine.

• #7 Hydronephrosis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/15417-hydronephrosis

  Hydronephrosis may lead to loss of kidney function or kidney failure. However, prompt treatment reduces the risk of long-term complications. […] Getting a diagnosis from your healthcare provider quickly is important because hydronephrosis can cause long-term kidney damage. […] Your provider will diagnose hydronephrosis with: Physical examination: Your provider will ask you about any symptoms you’re having and examine the area near your kidneys and bladder for tenderness or swelling. […] A healthcare provider can detect hydronephrosis in a fetus as early as the first trimester on an ultrasound. It’s typically discovered during a 20-week ultrasound. […] The goal of treatment is to restore the flow of pee from your kidney and decrease the swelling and pressure. Treatment depends on the underlying condition, as that is the primary issue.

• #8 Hydronephrosis: Causes, Symptoms, Diagnosis and Treatment

  https://www.clevelandclinicabudhabi.ae/en/health-hub/health-resource/diseases-and-conditions/hydronephrosis

  How is hydronephrosis diagnosed? […] Physical examination: Your doctor will ask you about any symptoms you are having and will examine the area near the kidneys and bladder for tenderness or swelling. The doctor may ask about your medical history and your family’s medical history. Men may need to undergo a rectal exam to determine whether the prostate is enlarged. Women might require a pelvic exam to evaluate whether there are any problems with the uterus or ovaries. […] Urine tests: A urine sample will be collected and analyzed to find out if any blood cells, bacteria or abnormal cells are present. […] Blood tests: A complete blood count may be performed to determine whether an infection is present. Other tests such as a blood urea nitrogen (BUN) test or glomerular filtration rate may be done to evaluate kidney function. […] Imaging procedures: These tests may include X-rays, computed tomography (CT scan) or ultrasound.

• #9 Hydronephrosis: Causes, Symptoms, and Treatment

  https://www.webmd.com/a-to-z-guides/what-to-know-hydronephrosis

  If youre showing signs of hydronephrosis, its important to talk to your doctor. Getting diagnosed and treated can help prevent the condition from getting worse or leading to complications such as kidney damage. […] To make the diagnosis, your doctor might suggest: […] A physical examination. First, your doctor will ask about your symptoms and medical history. Then, theyll feel your abdomen to look for swelling or tenderness. They might also perform a rectal exam (for people with a penis) to look for signs of an enlarged prostate or pelvic exam (for people with a uterus) to examine the reproductive organs. Rectal and pelvic exams are when a doctor gently puts a gloved finger inside your body to feel for abnormalities. […] Urine tests. This is when you pee in a cup, or a doctor collects your pee with a catheter. They then check your pee for blood, crystals, and germs.

• #10 Hydronephrosis – Symptoms, Causes, Complications, Treatment PACE Hospitals – Best Hospitals in Hitech City, Hyderabad, India | Near Madhapur, Kukatpally, KPHB, Kondapur, Gachibowli, Jubilee Hills, Banjara HillsPACE Hospitals Contact Numbe

  https://www.pacehospital.com/hydronephrosis-symptoms-causes-complications-treatment-prevention

  Hydronephrosis is characterized by the enlargement and stretching of one or both kidneys due to urine buildup within them. This condition can affect individuals across all age groups, and is occasionally detected in unborn babies during standard pregnancy ultrasound screenings, referred to as antenatal hydronephrosis. If hydronephrosis is identified early and treated appropriately by a urologist/nephrologist, it usually does not result in any long-term issues. […] The nephrologist/ urologist diagnoses hydronephrosis by: Taking patient history, Physical examination – Rectal examination, Pelvic examination, Blood tests – Complete blood picture, Blood urea nitrogen (BUN), Urine tests – Urinalysis, Urine culture, Imaging tests – Computed tomography (CT), Magnetic resonance imaging (MRI), Renal nuclear scan, Intravenous pyelogram (IVP), Ultrasound of the kidney, abdomen, or pelvis, Cystoscope. […] The goal of treatment is to restore urine flow from the kidney and reduce oedema (swelling due to fluid accumulation) and pressure caused by fluid buildup. If the hydronephrosis is acute or unexpected, a stent or soft tube (nephrostomy tube) can be placed into the kidney to remove excess urine.

• #11 Hydronephrosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hydronephrosis/diagnosis-treatment/drc-20575279

  Diagnosis involves the steps that your healthcare team takes to find out if hydronephrosis is the cause of your symptoms. Your healthcare professional starts by asking you about your symptoms and doing a physical exam. You may be referred to a doctor called a urologist, who finds and treats conditions of the urinary system. […] Tests that can help find out if you have hydronephrosis can include: […] A blood test to check how well the kidneys work. […] A urine test to look for clues that infection or kidney stones may be causing a blockage. […] An ultrasound imaging exam to view the kidneys, bladder and other parts of the urinary tract. This test can help spot possible health conditions. […] An X-ray exam of the urinary tract that uses a special dye to outline the kidneys, ureters, bladder and urethra. This test is called a CT urogram. It captures images of the urinary tract before and after urination. […] Your healthcare professional also may suggest another imaging exam, such as an MRI. Another testing option called a MAG3 scan checks kidney function and drainage. […] During pregnancy, a routine ultrasound test often spots hydronephrosis in unborn babies.

• #12 The Diagnosis of Obstructive Hydronephrosis with Color Doppler Ultrasound

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5639898/

  The obstructive hydronephrosis is a term that implicates the structural and functional changes of the kidneys as a result of difficulties in the flow of urine. […] The Ultrasound is a suitable method of early detection of obstructive uropathies especially in cases of hydronephrosis. […] Basic exams and tests for the diagnosis of hydronephrosis include; ultrasound of the kidneys or abdomen, MRI of the abdomen, CT-scan of the kidneys or abdomen, intravenous pyelogram (IVP), (12, 13). […] All patients were presented with hydronephrosis. The hydronephrosis grade varied from the stage I up to the IV. […] The most common causes of hydronephrosis in our study were; kidney stone, ureteral stones, neck stenosis PU, pregnancy, infiltrating bladder cancer, bladder neck contracture, prostate adenoma, infiltrating prostatic carcinoma etc.

• #13 The Diagnosis of Obstructive Hydronephrosis with Color Doppler Ultrasound

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5639898/

  The ultrasound has a high sensitivity and should be used as a screening method followed by other methods, as necessary. […] We came to the conclusion that the main causes of hydronephrosis are kidney stone, followed by ureteral stones, in which, in a larger percentage, they appear with the II degree of hydronephrosis.

• #14 Diagnosing hydronephrosis using ultrasound | Medmastery

  https://www.medmastery.com/magazine/diagnosing-hydronephrosis-using-ultrasound?srsltid=AfmBOoqkBq23DvUAgWPI3WDd46qsMNnnYfEtda9Dn0Uu52gxBLRL9cFj

  Hydronephrosis is defined as, a dilation of the urinary collecting system of the kidney, due to obstruction. […] Following the identification of hydronephrosis, we must investigate further to find the underlying cause. […] In ultrasound, a dilated renal pelvis and dilated calyces leads us to the diagnosis of hydronephrosis, the large echo-free structure, here in the middle of the kidney, is the renal pelvis. […] If the ureter is dilated as well, like here, we say it is hydroureteronephrosis. […] There are four grades of hydronephrosis. […] In Grade 1 hydronephrosis, we see dilation of the renal pelvis and fluid-marked calyces, like here. […] In Grade 2 hydronephrosis, we have a dilation of the renal pelvis, the infundibula, and the calyces. […] In Grade 3 hydronephrosis, we see dilation of the infundibula and the calyces as well as the renal pelvis.

• #15 Diagnosing hydronephrosis using ultrasound | Medmastery

  https://www.medmastery.com/magazine/diagnosing-hydronephrosis-using-ultrasound?srsltid=AfmBOoqkBq23DvUAgWPI3WDd46qsMNnnYfEtda9Dn0Uu52gxBLRL9cFj

  In Grade 4 hydronephrosis, due to an occluding stone in the ureteropelvic junction, we can see an extensive dilation of the renal pelvis and calyces, which appear ballooned. […] So, if we see hydronephrosis, we have to investigate the reason. […] The most probable reason for hydronephrosis is occluding kidney stones, especially when it’s acute onset with right or left flank pain. […] Another benign reason for hydronephrosis is the ureteropelvic junction obstruction.

• #16 Hydronephrosis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/hydronephrosis?embed_domain=hackmd.io%2525252F%25252540yIPUAFeCSL2JsU8smR5nJQ%2525252Fbnjhjgjghjghjghfavicon.icoradiopaedia-icon-144.png&lang=gb

  Hydronephrosis (plural: hydronephroses) is defined as dilatation of the urinary collecting system of the kidney (the calyces, the infundibula, and the pelvis). […] Following the identification of hydronephrosis, appropriate further investigations must be undertaken to establish an underlying cause, such as urolithiasis, pelviureteric junction obstruction, malignancy such as cervical cancer, and retroperitoneal fibrosis. […] Ultrasound imaging of hydronephrosis will demonstrate a dilated pelvicalcyceal system. The severity is often classified into mild, moderate or severe hydronephrosis. […] CT will readily show hydronephrosis, and can also help identify the cause. […] A nuclear medicine diuretic renogram may be performed to assess for obstruction of urine and differentiate from other causes such as an extra-renal pelvis or parapelvic cysts. […] The radiologist may also play a part in procedures to treat the harmful effects of uncorrected hydronephrosis on renal function, such as placement of a percutaneous nephrostomy tube or antegrade ureteric stent insertion.

• #17 Hydronephrosis and Hydroureter Workup: Laboratory Studies, Imaging Studies, Procedures

  https://emedicine.medscape.com/article/436259-workup

  Although ultrasound can accurately identify hydronephrosis, it is less sensitive than computed tomography (CT) for detecting stones in the ureters. […] The combination of a plain film of the abdomen (including tomographic cuts to detect radiopaque calculi), ultrasonography, and, if necessary, CT scanning is adequate for diagnostic purposes in over 90% of cases. […] The advantages of intravenous pyelography (IVP) in relation to ultrasonography are that IVP has a very low false-positive rate, it can identify the site of obstruction, and it can help detect associated conditions such as papillary necrosis or calyceal blunting from previous infection. […] Diuretic renography is used to diagnose urinary tract obstruction in infants with persistent hydronephrosis and is usually ordered after a VCUG has demonstrated no vesicoureteral reflux.

• #18 Hydronephrosis: Causes, Symptoms, Treatment, Diagnosis and More

  https://www.medicinenet.com/hydronephrosis/article.htm

  CT scan of the abdomen can be performed to evaluate the kidney anatomy and make the diagnosis of hydronephrosis. It also may allow the health care practitioner to look for the underlying cause including kidney stones or structures that are compressing the urinary collecting system. […] Ultrasound is another imaging study that can be done to look for hydronephrosis. The quality of the test depends upon the skill of the ultrasonographer to evaluate the structures in the abdomen and retroperitoneum. Hydronephrosis ultrasound is a non-invasive, quick procedure for screening purposes, and is also useful in women who are pregnant where radiation concerns exist. […] The goal of hydronephrosis treatment is to restart the free flow of urine from the kidney and decrease the swelling and pressure that builds up and decreases kidney function.

• #19 Hydronephrosis | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/hydronephrosis-urinary-tract-dilation

  MRI is a radiation-free diagnostic procedure that uses a combination of a large magnet, radiofrequencies and a computer to produce detailed images of the body. […] Magnetic resonance urography (MRU) also requires an intravenous line (IV) to inject a contrast called gadolinium, and a tube (catheter) will also be placed into your childs bladder.

• #20 Hydronephrosis and Hydroureter Workup: Laboratory Studies, Imaging Studies, Procedures

  https://emedicine.medscape.com/article/436259-workup

  Diuretic renography includes two phases. First, radioisotope is injected intravenously and renal parenchymal (cortical) uptake is measured during the first 2-3 minutes. […] In a series of 39 infants with antenatal unilateral hydronephrosis followed without surgery, diuretic renography indicated obstruction in 24 patients whose renal function never decreased and who thus did not have obstruction. […] Magnetic resonance urography (MRU) in children is becoming more commonly used in the diagnosis and management of congenital uropathies such as UPJ obstruction.

• #21 Hydronephrosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hydronephrosis/diagnosis-treatment/drc-20575279

  Diagnosis involves the steps that your healthcare team takes to find out if hydronephrosis is the cause of your symptoms. Your healthcare professional starts by asking you about your symptoms and doing a physical exam. You may be referred to a doctor called a urologist, who finds and treats conditions of the urinary system. […] Tests that can help find out if you have hydronephrosis can include: […] A blood test to check how well the kidneys work. […] A urine test to look for clues that infection or kidney stones may be causing a blockage. […] An ultrasound imaging exam to view the kidneys, bladder and other parts of the urinary tract. This test can help spot possible health conditions. […] An X-ray exam of the urinary tract that uses a special dye to outline the kidneys, ureters, bladder and urethra. This test is called a CT urogram. It captures images of the urinary tract before and after urination. […] Your healthcare professional also may suggest another imaging exam, such as an MRI. Another testing option called a MAG3 scan checks kidney function and drainage. […] During pregnancy, a routine ultrasound test often spots hydronephrosis in unborn babies.

• #22 Antenatal hydronephrosis tests, diagnosis and treatment | infoKID

  https://infokid.org.uk/conditions/antenatal-hydronephrosis/antenatal-hydronephrosis-tests-diagnosis-and-treatment/

  Your doctor may also arrange a DMSA scan, which checks for any damage in the kidneys, and/or a MAG3 scan, which is used to find out how well urine is draining from each kidney. […] An MCUG (sometimes called a VCUG) checks how your baby is passing urine, and whether there is any reflux (when urine passes back up towards the kidneys). […] In a very small number of cases, an operation may be recommended during pregnancy if there is little or no amniotic fluid around the baby growing in the womb. […] Occasionally, a baby needs an operation to correct the problem that is causing the hydronephrosis. If your baby needs treatment, a paediatric urologist will explain what will happen. […] Many babies with antenatal hydronephrosis are followed-up in clinic or hospital to check that there are no long-term problems. […] A small number of children who had antenatal hydronephrosis caused by other problems have long-term problems with their bladder or kidneys. Your doctor will give you more information.

• #23 Antenatal hydronephrosis tests, diagnosis and treatment | infoKID

  https://infokid.org.uk/conditions/antenatal-hydronephrosis/antenatal-hydronephrosis-tests-diagnosis-and-treatment/

  Your doctor may also arrange a DMSA scan, which checks for any damage in the kidneys, and/or a MAG3 scan, which is used to find out how well urine is draining from each kidney. […] An MCUG (sometimes called a VCUG) checks how your baby is passing urine, and whether there is any reflux (when urine passes back up towards the kidneys). […] In a very small number of cases, an operation may be recommended during pregnancy if there is little or no amniotic fluid around the baby growing in the womb. […] Occasionally, a baby needs an operation to correct the problem that is causing the hydronephrosis. If your baby needs treatment, a paediatric urologist will explain what will happen. […] Many babies with antenatal hydronephrosis are followed-up in clinic or hospital to check that there are no long-term problems. […] A small number of children who had antenatal hydronephrosis caused by other problems have long-term problems with their bladder or kidneys. Your doctor will give you more information.

• #24 Hydronephrosis and Hydroureter Workup: Laboratory Studies, Imaging Studies, Procedures

  https://emedicine.medscape.com/article/436259-workup

  Urinalysis is used to assess for signs of infection. Pyuria suggests the presence of infection. Microscopic hematuria may indicate the presence of a stone or tumor. […] Serum chemistry studies can reveal an elevation of blood urea nitrogen (BUN) and creatinine levels, which may be the result of bilateral hydronephrosis and hydroureter. In addition, hyperkalemia can be a life-threatening condition. […] Early diagnosis of urinary tract obstruction is important because most cases can be corrected and a delay in therapy can lead to irreversible renal injury. […] Radiologic tests are generally used to exclude obstruction at the level of the ureters or above by detecting dilatation of the collecting system. […] Renal ultrasonography is the test of choice to exclude urinary tract obstruction, avoiding the potential allergic and toxic complications of radiocontrast media.

• #25 Hydronephrosis: Understanding Causes, Diagnosis and Treatment

  https://www.instituteofurology.in/hydronephrosis-understanding-causes-diagnosis-and-treatment/

  Urinalysis: Checks for signs of infection, blood, or other abnormalities in the urine. […] Blood Tests: Evaluate kidney function and detect any underlying health issues. […] Urine Culture: Identifies the presence of bacteria in cases of suspected UTI. […] Diuretic Renography: Assesses kidney function and drainage using a radioactive tracer and diuretic medication. […] Cystoscopy: A scope inserted into the bladder to inspect for obstructions or abnormalities.

• #26 Hydronephrosis and Hydroureter Workup: Laboratory Studies, Imaging Studies, Procedures

  https://emedicine.medscape.com/article/436259-workup

  Urinalysis is used to assess for signs of infection. Pyuria suggests the presence of infection. Microscopic hematuria may indicate the presence of a stone or tumor. […] Serum chemistry studies can reveal an elevation of blood urea nitrogen (BUN) and creatinine levels, which may be the result of bilateral hydronephrosis and hydroureter. In addition, hyperkalemia can be a life-threatening condition. […] Early diagnosis of urinary tract obstruction is important because most cases can be corrected and a delay in therapy can lead to irreversible renal injury. […] Radiologic tests are generally used to exclude obstruction at the level of the ureters or above by detecting dilatation of the collecting system. […] Renal ultrasonography is the test of choice to exclude urinary tract obstruction, avoiding the potential allergic and toxic complications of radiocontrast media.

• #27 Hydronephrosis: Causes, Symptoms, and Treatment

  https://www.webmd.com/a-to-z-guides/what-to-know-hydronephrosis

  Blood tests. Your doctor might check your creatinine, estimated glomerular filtration rate (a measure of how well your kidneys are working), blood urea nitrogen (BUN), and other indicators of kidney function. They might also suggest a complete blood count to check for infections. […] Imaging procedures. Ultrasounds, MRIs, and CT scans can help doctors get a better look at whats happening inside your body. Sometimes, the doctor might inject you with a special dye, which highlights the pee so it’s easier to see in the imaging. Ultrasounds are also used for pregnant people. At 20 weeks, a doctor can perform an ultrasound to tell if your fetus has hydronephrosis.

• #28 Hydronephrosis | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/hydronephrosis-urinary-tract-dilation

  Hydronephrosis can be detected on an ultrasound as early as the first trimester of pregnancy and is typically seen on the anatomy ultrasound around 20 weeks gestation. […] In most cases, if your child is diagnosed with hydronephrosis before birth, youll receive follow-up ultrasounds for the remainder of your pregnancy to track your childs kidney health. […] A renal bladder ultrasound uses sound waves to outline the kidneys and bladder. It will enable us to see the degree of your childs hydronephrosis. […] In a voiding cystourethrogram (VCUG), a tube (catheter) is placed through your childs urethra and into their bladder. […] A MAG III renal scan may be performed to determine how each of your childs kidneys are functioning and how well each kidney drains into their ureter and down into the bladder.

• #29 Hydronephrosis – UChicago Medicine

  https://www.uchicagomedicine.org/comer/conditions-services/urology/hydronephrosis

  In some cases, your pediatric urologist will recommend a test called a voiding cystourethrogram (VCUG). […] Additional testing is important because diagnosing and treating a potential abnormality early can prevent urinary tract infections and permanent kidney damage or scarring. […] A VCUG provides important information about the shape and size of your child’s bladder, the bladder neck or opening, and the tubes that drain the urine from the kidneys into the bladder, called ureters. […] Some conditions causing hydronephrosis will need to be corrected with surgery. […] Pyeloplasty is the surgical reconstruction of the renal pelvis to drain and decompress the kidney. […] The goal of the surgery is to relieve a uretero-pelvic junction (UPJ) obstruction.

• #30 Hydronephrosis and Upper Urinary Tract Obstruction: Differential Diagnosis

  https://www.urology-textbook.com/hydronephrosis.html

  Hydronephrosis: descriptive term, Greek meaning water (hydro) in kidney (nephros): dilatation of the renal pelvis and/or calyces. Hydronephrosis can be present without relevant obstruction. […] Renal ultrasound: hydronephrosis grade II with dilatation of the renal pelvis and calyces. […] Diagnostic Workup in Hydronephrosis […] Laboratory tests: urine analysis (sediment microscopy), serum electrolytes and creatinine. […] Renal scintigraphy: to differentiate between relevant obstruction or dilatation of the calyceal system without obstruction. Renal scintigraphy can determine renal function and the need for surgical interventions. […] Retrograde pyelography and ureterorenoscopy: necessary for diagnosis and treatment of upper urinary tract obstruction (ureteral stenting, ureterotomy).

• #31

  https://www.nhs.uk/conditions/hydronephrosis/diagnosis/

  Hydronephrosis is usually diagnosed using an ultrasound scan. Further tests may be needed to find out the cause of the condition. […] You may need a number of additional tests to help determine the cause of hydronephrosis. […] Hydronephrosis may be diagnosed in your baby while you’re pregnant, usually during a routine pregnancy ultrasound scan at around 20 weeks. This is known as antenatal hydronephrosis. […] If your baby is diagnosed with antenatal hydronephrosis, you may need to have extra ultrasound scans during your pregnancy to check your baby is growing normally and their kidneys are not getting too large. […] Your baby may need to have scans after they’re born to monitor their condition and see if treatment is necessary.

• #32 Frontiers | Prenatal Diagnosis and Findings in Ureteropelvic Junction Type Hydronephrosis

  https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2020.00492/full

  UPJHN is the most common cause of persistent antenatal hydronephrosis. It is usually unilateral and three times more in male fetuses. UPJHN may be 10–30% bilateral and should be managed cautiously for the deterioration of renal functions. In all cases with prenatal UPJHN, AP renal pelvis diameter, presence and localization of calyx dilation, renal parenchymal features, presence of urinoma and oligohydramnios should be assessed. Patients in the high-risk group should be monitored during the prenatal period with an interval of 2–4 weeks, however patient monitoring should be customized according to the other negative findings. When UPJHN is detected during the prenatal period, consulting with pediatric urologists before delivery may contribute the postnatal management plans. […] […] Congenital hydronephrosis is one of the most common anomalies encountered at the prenatal ultrasound evaluation. It is observed in 1–4% of all pregnancies. Prenatal urinary system evaluation should preferably follow an anatomical sequence in order to identify the cause of the dilation. Therefore, urinary system examination in the prenatal period should demonstrate position of bilateral kidneys, dilation of renal pelvis and presence of calyx dilation (central and peripheral), echogenicity of kidney parenchyma, both ureters, bladder size and wall thickness, and anatomy of the external genitalia. […]

• #33 The Fetal Medicine Foundation

  https://fetalmedicine.org/education/fetal-abnormalities/urinary-tract/hydronephrosis

  Hydronephrosis […] Prevalence: […] 1 in 500 births. […] Ultrasound diagnosis: […] Dilatation of the collecting system of the kidney observed in the standard transverse view of the abdomen. Ureters and bladder are normal. […] On the basis of the anteroposterior diameter of the pelvis the condition is divided into: […] Mild (only renal pelvis): 4-7 mm in the 2nd trimester; 7-9 mm in the 3rd. […] Moderate (pelvis and calyces): 8-10 mm in the 2nd trimester; 10-15 mm in the 3rd. […] Severe (cortical thinning): 10 mm in the 2nd trimester; 15 mm in the 3rd. […] Associated abnormalities: […] Chromosomal defects: low risk in isolated forms. […] Abnormalities of the contralateral kidney: multicystic kidney, ectopia, renal agenesis. […] Associated syndromes are found in 5% of cases.

• #34 The Fetal Medicine Foundation

  https://fetalmedicine.org/education/fetal-abnormalities/urinary-tract/hydronephrosis

  Investigations: […] Detailed ultrasound examination (especially of the contralateral kidney). […] Karyotyping should be offered only if other markers are present. […] Follow up: […] Ultrasound scans every 4 weeks to monitor the evolution of hydronephrosis and assess amniotic fluid volume. […] Delivery: […] Standard obstetric care and delivery. […] Prognosis: […] In the majority of cases, the condition remains stable or resolves in the neonatal period. In about 20% of cases, there may be an underlying ureteropelvic junction obstruction or vesicoureteric reflux that requires postnatal follow-up and possible surgery. Moderate hydronephrosis is usually progressive and in more than 50% of cases surgery is necessary during the first 2 years of life. […] Recurrence: […] Isolated: no increased risk of recurrence.

• #35 Antenatal hydronephrosis tests, diagnosis and treatment | infoKID

  https://infokid.org.uk/conditions/antenatal-hydronephrosis/antenatal-hydronephrosis-tests-diagnosis-and-treatment/

  The 20 week antenatal ultrasound scan looks at the baby growing in the womb and measures the size of the renal pelvis. Antenatal hydronephrosis may be suspected if this is larger than usual. […] Your obstetrician may refer you to specialist healthcare professionals, such as a paediatric nephrologist (a doctor who treats children with kidney problems) or a paediatric urologist (a surgeon who treats children with problems of the urinary system). You can speak with these doctors about possible complications and their management. […] You may need to come back to the hospital for your baby to have imaging tests (scans). These use special scanners that take pictures of the inside of their body. […] The first test is normally an ultrasound scan, which is similar to the scan mothers have in pregnancy. It looks at the shape and size of the kidneys and other parts of the urinary system.

• #36 Hydronephrosis: Symptoms, Diagnosis and Treatment | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/hydronephrosis

  Hydronephrosis is usually determined on imaging studies such as renal ultrasounds, CT scan or MRIs. […] Much of the hydronephrosis seen in children is diagnosed prior to birth during a prenatal ultrasound of the fetus which checks the organs and development of the baby before birth. […] Most hydronephrosis in children is first diagnosed with a renal ultrasound. Other tests used may include one or more of the following: voiding cystogram, nuclear medicine renal scan, MRI or CT scan. Depending on the severity of hydronephrosis and its cause, additional follow up studies are usually necessary over time to track the improvement or worsening of the kidney swelling.

• #37 Hydronephrosis | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/hydronephrosis

  Signs of hydronephrosis may first show up on a routine prenatal ultrasound (sonography). The test transmits high-frequency sound waves into the uterus. The echoes that bounce back are recorded and made into an image of your baby. It will show the size and shape of your child’s kidneys, as well as the amount of amniotic fluid. It also can help reveal obstructions in the urinary system. […] For newborns and older children, doctors may use some or all of the following tests to help determine the cause and nature of the hydronephrosis: Renal ultrasound (RUS), Voiding cystourethrogram (VCUG), Renal scan (MAG 3). […] After considering the nature and cause of the hydronephrosis, doctors will decide between recommending observation or surgery. […] If postnatal testing shows your child has mild to moderate hydronephrosis, your doctor may recommend allowing time for the condition to correct itself on its own. […] Only in severe cases would surgery be needed. The goal of the operation is to reduce the swelling and pressure in the kidney by restoring the free flow of urine.

• #38 Hydronephrosis: Symptoms, Causes and Diagnosis

  https://www.medicoverhospitals.in/diseases/hydronephrosis/

  Diagnosed prenatally via ultrasound, followed by monitoring with serial scans for blockage and kidney function categorizing as mild, moderate, or severe. […] Ultrasound and radionuclide scans assess hydronephrosis and renal function. […] Treatment for hydronephrosis depends on the underlying cause and may include pain management, antibiotics for infections, procedures to remove kidney stones or correct obstructions, and surgery in severe cases. […] Hydronephrosis can be a serious condition if left untreated, potentially leading to kidney damage or failure. However, with proper diagnosis and treatment, the prognosis is generally good. […] Yes, if left untreated, hydronephrosis can lead to complications such as kidney damage, kidney failure, and urinary tract infections.

• #39 Prenatal Hydronephrosis | Department of Urology | UPMC

  https://www.upmc.com/services/urology/conditions/prenatal-hydronephrosis

  Hydronephrosis is typically diagnosed before birth in a prenatal ultrasound. It also may be suspected in a child who experiences a urinary tract infection or abdominal pain. […] The most important diagnostic test is the ultrasound. This can show how dilated the kidney is, whether both kidneys are involved, and whether the ureter is also dilated or the bladder is distended. […] Additionally, the ultrasound can give valuable information about the appearance of the functioning part of the kidney. […] The diagnosis of reflux is made using an x-ray called a voiding cystourethrogram (VCUG). A urinary catheter (tube) is placed into the child’s bladder and fills the bladder with x-ray dye. During urination, the path of the dye is followed. If it goes up toward the kidneys, reflux is diagnosed.

• #40 Prenatal Hydronephrosis | Department of Urology | UPMC

  https://www.upmc.com/services/urology/conditions/prenatal-hydronephrosis

  UPJ obstruction is often confirmed with a test called diuretic renal scan (DRS). A tiny amount of weak radioactive material is injected into a vein. A scanner follows the tracer’s progress through the urinary system. If all or most of the tracer remains in the kidney and does not wash out in the urine, blockage is diagnosed.

• #41 Hydronephrosis | UNC Department of Urology

  https://www.med.unc.edu/urology/pediatrics/pediatric-conditions/hydronephrosis/

  Treatment options depend on the severity of the hydronephrosis and the result of the studies. However, in general, the severity of hydronephrosis often gives some clue about treatment. […] If your child’s hydronephrosis is mild (grade 1 or 2) or if your child has moderate hydronephrosis and the kidney functions well and is growing normally, your child may undergo observation. […] Surgery is recommended only in severe cases when kidney function is at risk either due to obstruction or recurrent UTIs. The goal of the operation is to open the obstruction. […] If your child requires surgery, the overall success rate is around 95%, incisions are typically very small and children handle surgery well with mild-moderate discomfort.

• #42 Hydronephrosis and Hydroureter – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK563217/

  The cause of urinary obstruction can be broadly classified as intrinsic and extrinsic compression. […] Nephrolithiasis is the most common cause of hydroureteronephrosis in young adults. […] Hydronephrosis is commonly seen in up to 80% of pregnant women. […] The obstruction of the outward flow of urine leads to an increase in the hydrostatic pressure of the collecting system. […] If the obstruction is not relieved, it can lead to kidney scarring and permanent kidney damage with the compromise of glomerular and tubular function. […] The overall prognosis of renal recovery after the obstruction is relieved depends on the duration and severity of obstruction. […] Urinary tract infection is the most common complication of hydronephrosis. […] Patients should be educated to seek care promptly when they have these symptoms. […] Hydronephrosis and hydroureter are frequently encountered in all age groups, and all types of practices and are best managed with an interprofessional team approach. […] The involvement of nephrologists and urologists early in the diagnosis will improve outcomes.

• #43 Hydronephrosis and Hydroureter: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/436259-overview

  The etiology and presentation of hydronephrosis and/or hydroureter in adults differ from that in neonates and children. […] Hydronephrosis or hydroureter is a normal finding in pregnant women, resulting from progesterone effects and compression of the ureters by the enlarging uterus. […] Hydronephrosis can result from anatomic or functional processes interrupting the flow of urine. This interruption can occur anywhere along the urinary tract from the kidneys to the urethral meatus. […] The rise in ureteral pressure leads to marked changes in glomerular filtration, tubular function, and renal blood flow. […] The extent and persistence of these functional insults is directly related to the duration and extent of the obstruction. […] To distinguish acute and chronic hydronephrosis, one may consider acute as hydronephrosis that, when corrected, allows full recovery of renal function. Conversely, in chronic hydronephrosis the loss of function is irreversible even with correction of the obstruction.

• #44 Renal Ultrasound: Hydronephrosis and Stones — BROWN EMERGENCY MEDICINE BLOG

  http://brownemblog.com/blogposts/2022/1/21/renal-ultrasound-hydronephrosis-and-stones

  Hydronephrosis is swelling in the kidney due to backup of urine; often from an internal blockage of the ureter (such as in renal colic) or extrinsic pressure and blockage on the ureter (such as from a malignancy, or abdominal aortic aneurysm). […] There are various grades of hydronephrosis: Mild: In mild hydronephrosis, the renal pelvis will appear fluid filled, though the calyces are likely still collapsed. […] Moderate: The calyces in this state will now appear to be open, this is often referred to as a Bears Paw due to the dilated collecting system. […] Severe: In this state, the calyces will appear largely filled with fluid and will appear to coalesce due to swelling. […] Although ultrasound is 90% sensitive for detecting the hydronephrosis which can be caused by ureteral stones.

• #45 Hydronephrosis and Hydroureter Workup: Laboratory Studies, Imaging Studies, Procedures

  https://emedicine.medscape.com/article/436259-workup

  Although ultrasound can accurately identify hydronephrosis, it is less sensitive than computed tomography (CT) for detecting stones in the ureters. […] The combination of a plain film of the abdomen (including tomographic cuts to detect radiopaque calculi), ultrasonography, and, if necessary, CT scanning is adequate for diagnostic purposes in over 90% of cases. […] The advantages of intravenous pyelography (IVP) in relation to ultrasonography are that IVP has a very low false-positive rate, it can identify the site of obstruction, and it can help detect associated conditions such as papillary necrosis or calyceal blunting from previous infection. […] Diuretic renography is used to diagnose urinary tract obstruction in infants with persistent hydronephrosis and is usually ordered after a VCUG has demonstrated no vesicoureteral reflux.

• #46 Hydronephrosis and Hydroureter: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/436259-overview

  The etiology and presentation of hydronephrosis and/or hydroureter in adults differ from that in neonates and children. […] Hydronephrosis or hydroureter is a normal finding in pregnant women, resulting from progesterone effects and compression of the ureters by the enlarging uterus. […] Hydronephrosis can result from anatomic or functional processes interrupting the flow of urine. This interruption can occur anywhere along the urinary tract from the kidneys to the urethral meatus. […] The rise in ureteral pressure leads to marked changes in glomerular filtration, tubular function, and renal blood flow. […] The extent and persistence of these functional insults is directly related to the duration and extent of the obstruction. […] To distinguish acute and chronic hydronephrosis, one may consider acute as hydronephrosis that, when corrected, allows full recovery of renal function. Conversely, in chronic hydronephrosis the loss of function is irreversible even with correction of the obstruction.

• #47 Hydronephrosis | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/1688730/all/Hydronephrosis?q=Prostate+cancer

  Pediatric diagnostic algorithm differs from adult due to different differential diagnosis necessitating age-appropriate testing. […] Physiologic hydronephrosis in pregnancy is more prominent on the right than left and can be seen in up to 80% of pregnant women. […] If symptomatic and refractory to medical management, ureteric calculus should be considered and urinary infection must be excluded.

• #48 Hydronephrosis and Hydroureter – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK563217/

  The cause of urinary obstruction can be broadly classified as intrinsic and extrinsic compression. […] Nephrolithiasis is the most common cause of hydroureteronephrosis in young adults. […] Hydronephrosis is commonly seen in up to 80% of pregnant women. […] The obstruction of the outward flow of urine leads to an increase in the hydrostatic pressure of the collecting system. […] If the obstruction is not relieved, it can lead to kidney scarring and permanent kidney damage with the compromise of glomerular and tubular function. […] The overall prognosis of renal recovery after the obstruction is relieved depends on the duration and severity of obstruction. […] Urinary tract infection is the most common complication of hydronephrosis. […] Patients should be educated to seek care promptly when they have these symptoms. […] Hydronephrosis and hydroureter are frequently encountered in all age groups, and all types of practices and are best managed with an interprofessional team approach. […] The involvement of nephrologists and urologists early in the diagnosis will improve outcomes.

• #49 Hydronephrosis – UChicago Medicine

  https://www.uchicagomedicine.org/comer/conditions-services/urology/hydronephrosis

  Hydronephrosis is the term used to describe the extra urine seen in the kidney, due to slow drainage or obstruction somewhere between the renal pelvis that is the junction of the kidney and ureter entry into the bladder called the ureterovesical junction. […] In some cases, however, hydronephrosis may not be recognized until after birth or later in childhood. […] The hydronephrosis depends on the extent of the blockage and the amount of stretching of the kidney. […] Hydronephrosis ranges from mild to moderate to severe or graded based on a scale of 1 to 4 (4 being severe) by the society of fetal urology (SFU). […] The exact cause of the obstruction may not be known until special tests are performed. […] If the hydronephrosis did not go away before birth, your baby will need tests and possibly treatment after birth depending on the severity of the condition.

• #50 Role of Point-of-Care Ultrasound (POCUS) in Grading of Hydronephrosis – A Simple Approach – Point-of-Care Ultrasound Certification Academy

  https://www.pocus.org/role-of-pocus-in-grading-hydronephrosis-a-simple-approach/

  Point-of-Care Ultrasound (POCUS) is considered a sensitive modality to diagnose unilateral hydronephrosis – the dilatation of the major and or minor calyces and the renal pelvis due to an obstruction to the flow of urine from the pelvicalyceal system. […] Hydronephrosis is defined as the dilatation of the major and or minor calyces and the renal pelvis due to an obstruction to the flow of urine from the pelvicalyceal system. It could be due to a calculus or an external compression on the ureter due to a mass or even due to urinary bladder outlet obstruction. […] Point-of-Care Ultrasound (POCUS) is considered a sensitive modality to diagnose unilateral hydronephrosis. One study reported a sensitivity range of POCUS to be 72-83% to diagnose hydronephrosis as compared to CT scan. The study reported that 100% of patients with stones 6 mm were diagnosed using POCUS.

• #51 Prenatal Diagnosis of Severe Fetal Hydronephrosis Due to Pyeloureteral Junction Syndrome with False Neonatal Resolution

  https://www.mdpi.com/2673-3897/2/4/17

  A case of severe fetal hydronephrosis due to isolated bilateral stenosis of the pyelo-ureteral junction was diagnosed at our centre. […] The goal of prenatal management is to detect those cases of antenatal hydronephrosis that will require postnatal evaluation, timely referral to a paediatric urologist, and possible intervention. […] The Society of Fetal Urology (SFU) developed criteria for the diagnosis and grading of antenatal hydronephrosis based upon the degree of pelvic dilatation, number of calyces seen, and the presence and severity of parenchymal atrophy. […] In a meta-analysis of 1308 subjects with varying degrees of antenatal hydronephrosis, the risk of a pathologic postnatal outcome was estimated to be 88.3%, 45.1%, and 11.9% for severe, moderate, and mild antenatal hydronephrosis, respectively.

• #52 Hydronephrosis – UChicago Medicine

  https://www.uchicagomedicine.org/comer/conditions-services/urology/hydronephrosis

  Hydronephrosis is the term used to describe the extra urine seen in the kidney, due to slow drainage or obstruction somewhere between the renal pelvis that is the junction of the kidney and ureter entry into the bladder called the ureterovesical junction. […] In some cases, however, hydronephrosis may not be recognized until after birth or later in childhood. […] The hydronephrosis depends on the extent of the blockage and the amount of stretching of the kidney. […] Hydronephrosis ranges from mild to moderate to severe or graded based on a scale of 1 to 4 (4 being severe) by the society of fetal urology (SFU). […] The exact cause of the obstruction may not be known until special tests are performed. […] If the hydronephrosis did not go away before birth, your baby will need tests and possibly treatment after birth depending on the severity of the condition.

• #53 The Fetal Medicine Foundation

  https://fetalmedicine.org/education/fetal-abnormalities/urinary-tract/hydronephrosis

  Hydronephrosis […] Prevalence: […] 1 in 500 births. […] Ultrasound diagnosis: […] Dilatation of the collecting system of the kidney observed in the standard transverse view of the abdomen. Ureters and bladder are normal. […] On the basis of the anteroposterior diameter of the pelvis the condition is divided into: […] Mild (only renal pelvis): 4-7 mm in the 2nd trimester; 7-9 mm in the 3rd. […] Moderate (pelvis and calyces): 8-10 mm in the 2nd trimester; 10-15 mm in the 3rd. […] Severe (cortical thinning): 10 mm in the 2nd trimester; 15 mm in the 3rd. […] Associated abnormalities: […] Chromosomal defects: low risk in isolated forms. […] Abnormalities of the contralateral kidney: multicystic kidney, ectopia, renal agenesis. […] Associated syndromes are found in 5% of cases.

• #54 Frontiers | Prenatal Diagnosis and Findings in Ureteropelvic Junction Type Hydronephrosis

  https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2020.00492/full

  Fetal hydronephrosis is usually detected by ultrasound in the second trimester and defined as a renal pelvis diameter measurement above ≥4 mm. As gestational week progresses, definition of threshold values for dilation of the renal pelvis increases in the prenatal period. A measurement of ≤ 3 mm is considered normal in all gestational weeks. Mild hydronephrosis (APD 4–10 mm) may be a transient finding, or rarely associated with renal or chromosomal abnormalities. More severe dilation increases the risk of congenital anomalies of the kidney and urinary tract (CAKUT). […] […] The main cause of hydronephrosis is obstruction at any level of the urinary system. Some obstructive changes may develop very early in fetal life and may cause cystic-dysplastic pathology in the fetal kidney. Therefore, the initial time of obstruction and its consequences are as important as the severity of the dilation. UPJHN is the most common reason of ANH. Other causes include vesico-ureteral reflux, uretero-vesical junction obstruction, posterior urethral valve, and other rare incidents. Each is caused by different levels of obstruction and carries different ultrasonographic features. Accurate prenatal diagnosis will not only provide appropriate follow-up and prenatal interventions, but also help to prepare for the postnatal management. […]

• #55 U/S Clinics: Practical guidelines for diagnosing and treating fetal hydronephrosis

  https://www.contemporaryobgyn.net/view/us-clinics-practical-guidelines-diagnosing-and-treating-fetal-hydronephrosis

  A systematic review of the fetal urologic system can provide clues to the underlying etiology of fetal hydronephrosis. […] Obstructive lesions resulting in hydronephrosis are generally characterized by their function (unilateral or bilateral) and whether they obstruct the upper urologic tract (ureters, collecting system) or the lower tract (bladder outlet/urethra). […] The most common childhood cystic renal lesion, with an incidence of 1 in 3,000 livebirths, multicystic dysplastic kidney can be unilateral or bilateral. […] UPJ obstruction is the single most common cause of hydronephrosis in neonates, affecting 1 in 2,000 livebirths. […] Prenatal U/S has poor sensitivity for diagnosis of VUR and in utero decompression is not useful for this condition. […] A complex set of anomalies are responsible for fetal hydronephrosis. Identifying the level of obstruction is your first clue to the origins of the disease. Identifying severe or complex lesions can help you prepare parents and plan postnatal management. […] Even if you cannot identify the precise cause of hydronephrosis, postnatal follow-up is warranted if a lesion persists on a late second- or third-trimester U/S.

• #56 Role of Point-of-Care Ultrasound (POCUS) in Grading of Hydronephrosis – A Simple Approach – Point-of-Care Ultrasound Certification Academy

  https://www.pocus.org/role-of-pocus-in-grading-hydronephrosis-a-simple-approach/

  It is important to note that CT scan is the gold standard imaging modality to diagnose renal stones and hydronephrosis. However, that should be reserved for selective cases to avoid unnecessary exposure to ionizing radiation, higher cost and the increased time taken to perform the CT scan and obtain the results. POCUS has the advantage of low cost, availability at the point of care and no ionizing radiation. […] There are various methods of grading hydronephrosis. We will look at a simple approach to grade hydronephrosis in the point of care (POC) setting. Do note that there are various methods to grade hydronephrosis. […] There is one drawback with this grading system. It does not differentiate between mild, moderate or severe reduction of renal parenchymal thickness. Do note that if the patient has moderate or severe hydronephrosis then the patient must be referred to a specialist and if presenting to the emergency department with moderate or severe hydronephrosis then the kidney specialist must be consulted, and a stent should be considered to bypass the obstruction and plan for corrective measures.

• #57 U/S Clinics: Practical guidelines for diagnosing and treating fetal hydronephrosis

  https://www.contemporaryobgyn.net/view/us-clinics-practical-guidelines-diagnosing-and-treating-fetal-hydronephrosis

  A systematic review of the fetal urologic system can provide clues to the underlying etiology of fetal hydronephrosis. […] Obstructive lesions resulting in hydronephrosis are generally characterized by their function (unilateral or bilateral) and whether they obstruct the upper urologic tract (ureters, collecting system) or the lower tract (bladder outlet/urethra). […] The most common childhood cystic renal lesion, with an incidence of 1 in 3,000 livebirths, multicystic dysplastic kidney can be unilateral or bilateral. […] UPJ obstruction is the single most common cause of hydronephrosis in neonates, affecting 1 in 2,000 livebirths. […] Prenatal U/S has poor sensitivity for diagnosis of VUR and in utero decompression is not useful for this condition. […] A complex set of anomalies are responsible for fetal hydronephrosis. Identifying the level of obstruction is your first clue to the origins of the disease. Identifying severe or complex lesions can help you prepare parents and plan postnatal management. […] Even if you cannot identify the precise cause of hydronephrosis, postnatal follow-up is warranted if a lesion persists on a late second- or third-trimester U/S.

• #58 Hydronephrosis (Pediatric) | ColumbiaDoctors

  https://www.columbiadoctors.org/treatments-conditions/hydronephrosis-pediatric

  Hydronephrosis is a swelling or dilation within the kidney or ureter, the tube connecting the kidney to the bladder, and often results from a blockage at the top of the ureter near the kidney, an area known as the ureteropelvic junction (UPJ). […] Ultrasound can detect the fetal kidneys and bladder by 14 or 15 weeks gestation, though 20 weeks of pregnancy is the ideal time to detect hydronephrosis as the fetus is larger and the kidneys are producing urine. […] You will have an in-depth ultrasound study to confirm the diagnosis and evaluate the kidneys and bladder closely to ensure no other abnormalities are present. […] Every newborn with a prenatal diagnosis of hydronephrosis undergoes a detailed physical exam for signs of consequences from UPJ obstruction. […] If we find a UPJ obstruction on a newborn’s ultrasound, we will determine treatment based on the obstruction’s severity. […] Many cases of hydronephrosis resolve on their own before the baby’s birth. […] If UPJ obstruction is determined to be the cause of the hydronephrosis, the chances for future children with the same obstruction may be as high as 50 percent.

• #59 Prenatal Hydronephrosis | Department of Urology | UPMC

  https://www.upmc.com/services/urology/conditions/prenatal-hydronephrosis

  UPJ obstruction is often confirmed with a test called diuretic renal scan (DRS). A tiny amount of weak radioactive material is injected into a vein. A scanner follows the tracer’s progress through the urinary system. If all or most of the tracer remains in the kidney and does not wash out in the urine, blockage is diagnosed.

• #60 Hydronephrosis and Hydroureter – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK563217/

  The cause of urinary obstruction can be broadly classified as intrinsic and extrinsic compression. […] Nephrolithiasis is the most common cause of hydroureteronephrosis in young adults. […] Hydronephrosis is commonly seen in up to 80% of pregnant women. […] The obstruction of the outward flow of urine leads to an increase in the hydrostatic pressure of the collecting system. […] If the obstruction is not relieved, it can lead to kidney scarring and permanent kidney damage with the compromise of glomerular and tubular function. […] The overall prognosis of renal recovery after the obstruction is relieved depends on the duration and severity of obstruction. […] Urinary tract infection is the most common complication of hydronephrosis. […] Patients should be educated to seek care promptly when they have these symptoms. […] Hydronephrosis and hydroureter are frequently encountered in all age groups, and all types of practices and are best managed with an interprofessional team approach. […] The involvement of nephrologists and urologists early in the diagnosis will improve outcomes.

• #61 The Diagnosis of Obstructive Hydronephrosis with Color Doppler Ultrasound

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5639898/

  The ultrasound has a high sensitivity and should be used as a screening method followed by other methods, as necessary. […] We came to the conclusion that the main causes of hydronephrosis are kidney stone, followed by ureteral stones, in which, in a larger percentage, they appear with the II degree of hydronephrosis.

• #62 Hydronephrosis and Hydroureter Workup: Laboratory Studies, Imaging Studies, Procedures

  https://emedicine.medscape.com/article/436259-workup

  Although ultrasound can accurately identify hydronephrosis, it is less sensitive than computed tomography (CT) for detecting stones in the ureters. […] The combination of a plain film of the abdomen (including tomographic cuts to detect radiopaque calculi), ultrasonography, and, if necessary, CT scanning is adequate for diagnostic purposes in over 90% of cases. […] The advantages of intravenous pyelography (IVP) in relation to ultrasonography are that IVP has a very low false-positive rate, it can identify the site of obstruction, and it can help detect associated conditions such as papillary necrosis or calyceal blunting from previous infection. […] Diuretic renography is used to diagnose urinary tract obstruction in infants with persistent hydronephrosis and is usually ordered after a VCUG has demonstrated no vesicoureteral reflux.

• #63 Renal Ultrasound: Hydronephrosis and Stones — BROWN EMERGENCY MEDICINE BLOG

  http://brownemblog.com/blogposts/2022/1/21/renal-ultrasound-hydronephrosis-and-stones

  Although a patient with renal colic may exhibit a range of hydronephrosis on a bedside ultrasound, it is still very helpful information to guide your next steps. […] A patient who you are fairly certain has a kidney stone, and exhibits none or mild hydronephrosis, maybe able to go home once pain controlled and tolerating PO with a normal urinalysis and creatinine. […] Patients without infection and no significant obstruction are very likely to pass their stone on their own and are less likely to need advanced imaging unless you are concerned for alternative dangerous abdominal pathology. […] In contrast, a patient with moderate to severe hydronephrosis, or with evidence of a urinary tract infection may require a urologic consultation and potentially advanced imaging for interventional planning (eg how large and how proximal is the stone).

• #64 U/S Clinics: Practical guidelines for diagnosing and treating fetal hydronephrosis

  https://www.contemporaryobgyn.net/view/us-clinics-practical-guidelines-diagnosing-and-treating-fetal-hydronephrosis

  A systematic review of the fetal urologic system can provide clues to the underlying etiology of fetal hydronephrosis. […] Obstructive lesions resulting in hydronephrosis are generally characterized by their function (unilateral or bilateral) and whether they obstruct the upper urologic tract (ureters, collecting system) or the lower tract (bladder outlet/urethra). […] The most common childhood cystic renal lesion, with an incidence of 1 in 3,000 livebirths, multicystic dysplastic kidney can be unilateral or bilateral. […] UPJ obstruction is the single most common cause of hydronephrosis in neonates, affecting 1 in 2,000 livebirths. […] Prenatal U/S has poor sensitivity for diagnosis of VUR and in utero decompression is not useful for this condition. […] A complex set of anomalies are responsible for fetal hydronephrosis. Identifying the level of obstruction is your first clue to the origins of the disease. Identifying severe or complex lesions can help you prepare parents and plan postnatal management. […] Even if you cannot identify the precise cause of hydronephrosis, postnatal follow-up is warranted if a lesion persists on a late second- or third-trimester U/S.

• #65 What is Hydronephrosis In Children Or Infants? – Urology | UCLA Health

  https://www.uclahealth.org/medical-services/urology/conditions-treated/pediatric-conditions/what-hydronephrosis-children-or-infants

  Antenatal hydronephrosis, the most common urological problem found during prenatal ultrasound screening, refers to the fluid-filled enlargement of the kidney as a result of obstruction in its output of urine. It is usually detected in the fetus in the first trimester of pregnancy, though it can also be discovered later in the pregnancy or after birth. […] The initial approach to most cases of antenatal hydronephrosis is to perform regular ultrasound testing to carefully monitor kidney growth and function during the pregnancy, infancy and childhood. Usually, this is all that is necessary. […] Within the first few days after birth, the newborn’s kidneys are evaluated with an ultrasound. If hydronephrosis is still found, other tests are performed. A voiding cystourethrogram, in which a catheter is placed in the bladder, is used to rule out vesicouretal reflux, which is responsible for 25-30 percent of antenatal hydronephrosis cases.

• #66 Hydronephrosis: Causes, symptoms, diagnosis, and treatment

  https://www.medicalnewstoday.com/articles/322005

  Doctors typically use a hydronephrosis ultrasound scan to diagnose the condition. This type of scan uses sound waves to see the organs inside the body, allowing a doctor to see whether a persons kidneys are swollen. […] If a persons kidneys appear swollen on an ultrasound picture, the doctor may need to do more tests. These tests can help find the underlying cause of the hydronephrosis. […] A voiding cystourethrogram is a special X-ray that shows if reflux or obstruction is present. The doctor adds a dye to the urine in the bladder. This helps show the path of urine flow on an X-ray. Doctors use this test to diagnose VUR in adults and babies.

• #67 The Diagnosis of Obstructive Hydronephrosis with Color Doppler Ultrasound

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5639898/

  The obstructive hydronephrosis is a term that implicates the structural and functional changes of the kidneys as a result of difficulties in the flow of urine. […] The Ultrasound is a suitable method of early detection of obstructive uropathies especially in cases of hydronephrosis. […] Basic exams and tests for the diagnosis of hydronephrosis include; ultrasound of the kidneys or abdomen, MRI of the abdomen, CT-scan of the kidneys or abdomen, intravenous pyelogram (IVP), (12, 13). […] All patients were presented with hydronephrosis. The hydronephrosis grade varied from the stage I up to the IV. […] The most common causes of hydronephrosis in our study were; kidney stone, ureteral stones, neck stenosis PU, pregnancy, infiltrating bladder cancer, bladder neck contracture, prostate adenoma, infiltrating prostatic carcinoma etc.

• #68 Hydronephrosis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/hydronephrosis?embed_domain=hackmd.io%2525252F%25252540yIPUAFeCSL2JsU8smR5nJQ%2525252Fbnjhjgjghjghjghfavicon.icoradiopaedia-icon-144.png&lang=gb

  Hydronephrosis (plural: hydronephroses) is defined as dilatation of the urinary collecting system of the kidney (the calyces, the infundibula, and the pelvis). […] Following the identification of hydronephrosis, appropriate further investigations must be undertaken to establish an underlying cause, such as urolithiasis, pelviureteric junction obstruction, malignancy such as cervical cancer, and retroperitoneal fibrosis. […] Ultrasound imaging of hydronephrosis will demonstrate a dilated pelvicalcyceal system. The severity is often classified into mild, moderate or severe hydronephrosis. […] CT will readily show hydronephrosis, and can also help identify the cause. […] A nuclear medicine diuretic renogram may be performed to assess for obstruction of urine and differentiate from other causes such as an extra-renal pelvis or parapelvic cysts. […] The radiologist may also play a part in procedures to treat the harmful effects of uncorrected hydronephrosis on renal function, such as placement of a percutaneous nephrostomy tube or antegrade ureteric stent insertion.

• #69 Hydronephrosis and Hydroureter: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/436259-overview

  Hydronephrosis and hydroureter are common clinical conditions encountered not only by urologists but also by emergency medicine and primary care physicians. Hydronephrosis is defined as distention of the renal calyces and pelvis with urine as a result of obstruction of the outflow of urine distal to the renal pelvis. Analogously, hydroureter is defined as a dilation of the ureter. […] The presence of hydronephrosis or hydroureter can be physiologic or pathologic. It may be acute or chronic, unilateral or bilateral. It can be secondary to obstruction of the urinary tract, but it can also be present even without obstruction. […] Obstructive uropathy refers to the functional or anatomic obstruction of urinary flow at any level of the urinary tract. Obstructive nephropathy is present when the obstruction causes functional or anatomic renal damage. Rarely, obstructive nephropathy may occur in the absence of hydronephrosis.

• #70 Hydronephrosis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/15417-hydronephrosis

  Hydronephrosis may lead to loss of kidney function or kidney failure. However, prompt treatment reduces the risk of long-term complications. […] Getting a diagnosis from your healthcare provider quickly is important because hydronephrosis can cause long-term kidney damage. […] Your provider will diagnose hydronephrosis with: Physical examination: Your provider will ask you about any symptoms you’re having and examine the area near your kidneys and bladder for tenderness or swelling. […] A healthcare provider can detect hydronephrosis in a fetus as early as the first trimester on an ultrasound. It’s typically discovered during a 20-week ultrasound. […] The goal of treatment is to restore the flow of pee from your kidney and decrease the swelling and pressure. Treatment depends on the underlying condition, as that is the primary issue.

• #71 Hydronephrosis: Causes, Symptoms, Treatment, Diagnosis and More

  https://www.medicinenet.com/hydronephrosis/article.htm

  CT scan of the abdomen can be performed to evaluate the kidney anatomy and make the diagnosis of hydronephrosis. It also may allow the health care practitioner to look for the underlying cause including kidney stones or structures that are compressing the urinary collecting system. […] Ultrasound is another imaging study that can be done to look for hydronephrosis. The quality of the test depends upon the skill of the ultrasonographer to evaluate the structures in the abdomen and retroperitoneum. Hydronephrosis ultrasound is a non-invasive, quick procedure for screening purposes, and is also useful in women who are pregnant where radiation concerns exist. […] The goal of hydronephrosis treatment is to restart the free flow of urine from the kidney and decrease the swelling and pressure that builds up and decreases kidney function.

• #72 Hydronephrosis | UNC Department of Urology

  https://www.med.unc.edu/urology/pediatrics/pediatric-conditions/hydronephrosis/

  Treatment options depend on the severity of the hydronephrosis and the result of the studies. However, in general, the severity of hydronephrosis often gives some clue about treatment. […] If your child’s hydronephrosis is mild (grade 1 or 2) or if your child has moderate hydronephrosis and the kidney functions well and is growing normally, your child may undergo observation. […] Surgery is recommended only in severe cases when kidney function is at risk either due to obstruction or recurrent UTIs. The goal of the operation is to open the obstruction. […] If your child requires surgery, the overall success rate is around 95%, incisions are typically very small and children handle surgery well with mild-moderate discomfort.

• #73 Hydronephrosis | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/hydronephrosis

  Signs of hydronephrosis may first show up on a routine prenatal ultrasound (sonography). The test transmits high-frequency sound waves into the uterus. The echoes that bounce back are recorded and made into an image of your baby. It will show the size and shape of your child’s kidneys, as well as the amount of amniotic fluid. It also can help reveal obstructions in the urinary system. […] For newborns and older children, doctors may use some or all of the following tests to help determine the cause and nature of the hydronephrosis: Renal ultrasound (RUS), Voiding cystourethrogram (VCUG), Renal scan (MAG 3). […] After considering the nature and cause of the hydronephrosis, doctors will decide between recommending observation or surgery. […] If postnatal testing shows your child has mild to moderate hydronephrosis, your doctor may recommend allowing time for the condition to correct itself on its own. […] Only in severe cases would surgery be needed. The goal of the operation is to reduce the swelling and pressure in the kidney by restoring the free flow of urine.

• #74 Prenatal Hydronephrosis | UCSF Department of Urology

  https://urology.ucsf.edu/patient-care/children/Hydronephrosis

  The degree of hydronephrosis is used to assist in decision making with regard to treating the underlying cause of the hydronephrosis and the ultimate prognosis of patients. […] The special x-ray tests mentioned previously will help us to find the cause of the hydronephrosis. […] The decision to treat children with hydronephrosis with prophylactic antibiotics is affected by several factors but mainly the severity of the hydronephrosis. […] The goal of antibiotics is to prevent kidney infections that may occur as a result of the hydronephrosis. […] Typically, non-obstructive hydronephrosis (ie, hydronephrosis secondary to dilation at the ureterovesical junction, the place where the ureter meets the bladder; please see Figure 1) and grade 1 to 3 hydronephrosis secondary to uretero-pelvic junction type hydronephrosis do not need surgical intervention and resolve over time. […] Patients with grade IV hydronephrosis (severe) are the most likely to require surgery to prevent renal damage and recurrent infection.

• #75 Hydronephrosis: Causes, Symptoms, Treatment, Diagnosis and More

  https://www.medicinenet.com/hydronephrosis/article.htm

  The initial care for the patient is aimed at minimizing pain and preventing urinary tract infections. Otherwise, surgical intervention may be required. […] The timing of the procedure depends upon the underlying cause of hydronephrosis kidney and hydroureter and the associated medical conditions that may be present. […] Shock wave lithotripsy (SWL or extracorporeal shock wave lithotripsy) is the most common treatment for kidney stones in the U.S. […] For patients with urinary retention and an enlarged bladder as a cause of hydronephrosis, bladder catheterization may be all that is needed for initial treatment. […] The best treatment for hydronephrosis kidney depends on the underlying cause, severity, and duration of the condition and may include: Observation and monitoring: If hydronephrosis is mild and asymptomatic, especially in cases where it is detected incidentally, regular monitoring with imaging tests may be all that is needed.

• #76 Hydronephrosis: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/unilateral-hydronephrosis

  If a blocked ureter is causing your condition, your doctor might need to do any of the following: insert a ureteral stent, which is a tube that allows the ureter to drain into the bladder; insert a nephrostomy tube, which allows the blocked urine to drain through the back; prescribe antibiotics to control infection. […] If the cause of your hydronephrosis is a kidney stone, you may need surgery to remove it. […] If you receive treatment early, your outlook is good. Removal of the obstruction is essential for your kidney to return to normal functioning.

• #77 Hydronephrosis – UChicago Medicine

  https://www.uchicagomedicine.org/comer/conditions-services/urology/hydronephrosis

  In some cases, your pediatric urologist will recommend a test called a voiding cystourethrogram (VCUG). […] Additional testing is important because diagnosing and treating a potential abnormality early can prevent urinary tract infections and permanent kidney damage or scarring. […] A VCUG provides important information about the shape and size of your child’s bladder, the bladder neck or opening, and the tubes that drain the urine from the kidneys into the bladder, called ureters. […] Some conditions causing hydronephrosis will need to be corrected with surgery. […] Pyeloplasty is the surgical reconstruction of the renal pelvis to drain and decompress the kidney. […] The goal of the surgery is to relieve a uretero-pelvic junction (UPJ) obstruction.

• #78 Hydronephrosis | UNC Department of Urology

  https://www.med.unc.edu/urology/pediatrics/pediatric-conditions/hydronephrosis/

  Treatment options depend on the severity of the hydronephrosis and the result of the studies. However, in general, the severity of hydronephrosis often gives some clue about treatment. […] If your child’s hydronephrosis is mild (grade 1 or 2) or if your child has moderate hydronephrosis and the kidney functions well and is growing normally, your child may undergo observation. […] Surgery is recommended only in severe cases when kidney function is at risk either due to obstruction or recurrent UTIs. The goal of the operation is to open the obstruction. […] If your child requires surgery, the overall success rate is around 95%, incisions are typically very small and children handle surgery well with mild-moderate discomfort.

• #79 What is Hydronephrosis In Children Or Infants? – Urology | UCLA Health

  https://www.uclahealth.org/medical-services/urology/conditions-treated/pediatric-conditions/what-hydronephrosis-children-or-infants

  In cases in which obstruction or blockage threatens to severely damage the developing kidney and other organ systems affected by kidney function, a surgical procedure known as a pyeloplasty may prove necessary to correct the blockage. […] When the hydronephrosis is found not to be associated with reflux or obstruction, continued monitoring with periodic ultrasounds is generally all that is needed.

• #80 Management of hydronephrosis: a comprehensive review in pediatric urology perspective

  https://www.chikd.org/journal/view.php?number=808

  The debate over continuous antibiotic prophylaxis (CAP) versus observation for antenatal hydronephrosis (ANH) remains contentious, with limited conclusive evidence from two randomized controlled trials (RCTs). […] The European Association of Urology guidelines recommend surgery as the treatment of choice in patients with symptomatic UPJO. […] In POM, the primary indications for intervention include febrile UTI, urolithiasis, and abdominal symptoms. […] In summary, symptomatic patients (such as UTI and flank pain) in both of UPJO and POM are absolute indications for surgery, and in addition, if there is a decrease in renal function more than 10% during follow-up, worsening hydronephrosis, or poor renal function from the initial examination, a referral to a urologist is required.

• #81 Hydronephrosis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/15417-hydronephrosis

  If hydronephrosis is sudden and due to a blockage, your provider may place a nephrostomy tube through your skin into your kidney to drain excess pee. […] If you experience a UTI or your urinary tract is narrow due to infection, your provider will prescribe antibiotics to treat the infection. […] Yes, it can become a serious issue without prompt treatment. However, most cases are mild to moderate and don’t cause serious health problems. […] Hydronephrosis a condition where your kidneys become swollen due to pee building up can affect anyone.

• #82 Hydronephrosis: Causes, Symptoms, Treatment, Diagnosis and More

  https://www.medicinenet.com/hydronephrosis/article.htm

  The initial care for the patient is aimed at minimizing pain and preventing urinary tract infections. Otherwise, surgical intervention may be required. […] The timing of the procedure depends upon the underlying cause of hydronephrosis kidney and hydroureter and the associated medical conditions that may be present. […] Shock wave lithotripsy (SWL or extracorporeal shock wave lithotripsy) is the most common treatment for kidney stones in the U.S. […] For patients with urinary retention and an enlarged bladder as a cause of hydronephrosis, bladder catheterization may be all that is needed for initial treatment. […] The best treatment for hydronephrosis kidney depends on the underlying cause, severity, and duration of the condition and may include: Observation and monitoring: If hydronephrosis is mild and asymptomatic, especially in cases where it is detected incidentally, regular monitoring with imaging tests may be all that is needed.

• #83 Hydronephrosis: Diagnosis & treatment in Turkey

  https://www.turquiesante.com/en/treatment-of-hydronephrosis-736

  In addition, the accumulation of urine promotes the development of recurrent urinary tract infections and the formation of kidney stones. […] The goal of treatment is to restore normal urine flow, preserve kidney function and improve the patient’s quality of life. […] After treatment, regular follow-up is necessary to monitor kidney function and detect any recurrence. […] The length of your hospital stay will vary depending on the procedure and your overall health. […] Treatment of hydronephrosis is not without risk. In addition to urinary tract infections and bleeding, recurrent obstruction can lead to progressive loss of kidney function or even end-stage renal disease.

• #84 Prenatal Hydronephrosis | UCSF Department of Urology

  https://urology.ucsf.edu/patient-care/children/Hydronephrosis

  The degree of hydronephrosis is used to assist in decision making with regard to treating the underlying cause of the hydronephrosis and the ultimate prognosis of patients. […] The special x-ray tests mentioned previously will help us to find the cause of the hydronephrosis. […] The decision to treat children with hydronephrosis with prophylactic antibiotics is affected by several factors but mainly the severity of the hydronephrosis. […] The goal of antibiotics is to prevent kidney infections that may occur as a result of the hydronephrosis. […] Typically, non-obstructive hydronephrosis (ie, hydronephrosis secondary to dilation at the ureterovesical junction, the place where the ureter meets the bladder; please see Figure 1) and grade 1 to 3 hydronephrosis secondary to uretero-pelvic junction type hydronephrosis do not need surgical intervention and resolve over time. […] Patients with grade IV hydronephrosis (severe) are the most likely to require surgery to prevent renal damage and recurrent infection.

• #85 Antenatal hydronephrosis tests, diagnosis and treatment | infoKID

  https://infokid.org.uk/conditions/antenatal-hydronephrosis/antenatal-hydronephrosis-tests-diagnosis-and-treatment/

  Your doctor may also arrange a DMSA scan, which checks for any damage in the kidneys, and/or a MAG3 scan, which is used to find out how well urine is draining from each kidney. […] An MCUG (sometimes called a VCUG) checks how your baby is passing urine, and whether there is any reflux (when urine passes back up towards the kidneys). […] In a very small number of cases, an operation may be recommended during pregnancy if there is little or no amniotic fluid around the baby growing in the womb. […] Occasionally, a baby needs an operation to correct the problem that is causing the hydronephrosis. If your baby needs treatment, a paediatric urologist will explain what will happen. […] Many babies with antenatal hydronephrosis are followed-up in clinic or hospital to check that there are no long-term problems. […] A small number of children who had antenatal hydronephrosis caused by other problems have long-term problems with their bladder or kidneys. Your doctor will give you more information.

• #86 Pediatric Hydronephrosis – Conditions and Treatments | Children’s National Hospital

  https://www.childrensnational.org/get-care/health-library/hydronephrosis

  Hydronephrosis means that there is more urine in the kidneys and ureters than normal. […] Doctors typically diagnose hydronephrosis by: prenatal ultrasound, MRI, X-ray. […] Your child’s hydronephrosis may have been detected before through a routine prenatal ultrasound. In that case, your physician may refer you to our Zickler Family Prenatal Pediatrics Institute for a high-resolution (level II) ultrasound and MRI scans to evaluate your baby’s condition. […] Regardless of how you are referred for hydronephrosis evaluation, one of our pediatric urologists will decide on the ideal set of X-ray studies to understand your child’s urinary tract better. Those studies may include: Renal Bladder Ultrasound, VCUG, Mag-3 lasix renal scan. […] There are four main options for treatment, depending on the severity of hydronephrosis in your baby: Close observation for mild or moderate cases, including ultrasounds before and after birth; Antibiotics after your baby is born to prevent infection, in select cases where infection may be more likely to occur; Surgery to repair any urinary tract blockage, in more severe cases; Prenatal surgery to place a drainage tube in your baby’s bladder, in the most severe cases.

• #87 Hydronephrosis and Hydroureter – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK563217/

  The cause of urinary obstruction can be broadly classified as intrinsic and extrinsic compression. […] Nephrolithiasis is the most common cause of hydroureteronephrosis in young adults. […] Hydronephrosis is commonly seen in up to 80% of pregnant women. […] The obstruction of the outward flow of urine leads to an increase in the hydrostatic pressure of the collecting system. […] If the obstruction is not relieved, it can lead to kidney scarring and permanent kidney damage with the compromise of glomerular and tubular function. […] The overall prognosis of renal recovery after the obstruction is relieved depends on the duration and severity of obstruction. […] Urinary tract infection is the most common complication of hydronephrosis. […] Patients should be educated to seek care promptly when they have these symptoms. […] Hydronephrosis and hydroureter are frequently encountered in all age groups, and all types of practices and are best managed with an interprofessional team approach. […] The involvement of nephrologists and urologists early in the diagnosis will improve outcomes.

• #88 Hydronephrosis and Hydroureter: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/436259-overview

  Long-standing hydronephrosis may be associated with obstructive nephropathy and renal failure. […] Urinary stasis may result in infection, renal scarring, calculus formation, and sepsis. […] Urinary tract obstruction should be considered in all patients with otherwise unexplained renal insufficiency.

• #89 Hydronephrosis: Causes, Symptoms, Treatment, Diagnosis and More

  https://www.medicinenet.com/hydronephrosis/article.htm

  In severe cases where hydronephrosis causes permanent damage and kidney failure, dialysis or a kidney transplant may be necessary. Early detection and intervention are essential to prevent complications such as chronic kidney damage or loss of kidney function. The appropriate treatment plan for hydronephrosis kidney should be guided by a health care professional, often based on imaging studies, such as ultrasound and CT scans, and the severity of symptoms. […] If hydronephrosis remains untreated, the increased pressure within the kidney may decrease the ability of the kidney to filter blood, remove waste products, and make urine as well as regulate the electrolytes in the body. Hydronephrosis can lead to kidney infections, and in some cases, complete kidney function loss or death.

• #90 Hydronephrosis: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/unilateral-hydronephrosis

  If a blocked ureter is causing your condition, your doctor might need to do any of the following: insert a ureteral stent, which is a tube that allows the ureter to drain into the bladder; insert a nephrostomy tube, which allows the blocked urine to drain through the back; prescribe antibiotics to control infection. […] If the cause of your hydronephrosis is a kidney stone, you may need surgery to remove it. […] If you receive treatment early, your outlook is good. Removal of the obstruction is essential for your kidney to return to normal functioning.

• #91

  https://www.nhs.uk/conditions/hydronephrosis/

  Hydronephrosis does not generally cause any long-term problems if it’s diagnosed and treated promptly. […] You should see your doctor or contact 111 if you have any of these symptoms. […] They may refer you for an ultrasound scan to assess your kidneys. […] Find out about diagnosing hydronephrosis. […] If you have hydronephrosis, your treatment will depend on what’s causing the condition and how severe it is. […] In adults, the first stage of treatment is often to drain the urine out of your kidneys by inserting a tube called a catheter into your bladder or kidneys. […] Once the pressure has been relieved, the cause of the build-up of urine may need to be treated. […] Find out about how hydronephrosis is treated.

• #92 The Fetal Medicine Foundation

  https://fetalmedicine.org/education/fetal-abnormalities/urinary-tract/hydronephrosis

  Investigations: […] Detailed ultrasound examination (especially of the contralateral kidney). […] Karyotyping should be offered only if other markers are present. […] Follow up: […] Ultrasound scans every 4 weeks to monitor the evolution of hydronephrosis and assess amniotic fluid volume. […] Delivery: […] Standard obstetric care and delivery. […] Prognosis: […] In the majority of cases, the condition remains stable or resolves in the neonatal period. In about 20% of cases, there may be an underlying ureteropelvic junction obstruction or vesicoureteric reflux that requires postnatal follow-up and possible surgery. Moderate hydronephrosis is usually progressive and in more than 50% of cases surgery is necessary during the first 2 years of life. […] Recurrence: […] Isolated: no increased risk of recurrence.

• #93 Prenatal Diagnosis of Severe Fetal Hydronephrosis Due to Pyeloureteral Junction Syndrome with False Neonatal Resolution

  https://www.mdpi.com/2673-3897/2/4/17

  A case of severe fetal hydronephrosis due to isolated bilateral stenosis of the pyelo-ureteral junction was diagnosed at our centre. […] The goal of prenatal management is to detect those cases of antenatal hydronephrosis that will require postnatal evaluation, timely referral to a paediatric urologist, and possible intervention. […] The Society of Fetal Urology (SFU) developed criteria for the diagnosis and grading of antenatal hydronephrosis based upon the degree of pelvic dilatation, number of calyces seen, and the presence and severity of parenchymal atrophy. […] In a meta-analysis of 1308 subjects with varying degrees of antenatal hydronephrosis, the risk of a pathologic postnatal outcome was estimated to be 88.3%, 45.1%, and 11.9% for severe, moderate, and mild antenatal hydronephrosis, respectively.

• #94 Hydronephrosis and Hydroureter Workup: Laboratory Studies, Imaging Studies, Procedures

  https://emedicine.medscape.com/article/436259-workup

  Urinalysis is used to assess for signs of infection. Pyuria suggests the presence of infection. Microscopic hematuria may indicate the presence of a stone or tumor. […] Serum chemistry studies can reveal an elevation of blood urea nitrogen (BUN) and creatinine levels, which may be the result of bilateral hydronephrosis and hydroureter. In addition, hyperkalemia can be a life-threatening condition. […] Early diagnosis of urinary tract obstruction is important because most cases can be corrected and a delay in therapy can lead to irreversible renal injury. […] Radiologic tests are generally used to exclude obstruction at the level of the ureters or above by detecting dilatation of the collecting system. […] Renal ultrasonography is the test of choice to exclude urinary tract obstruction, avoiding the potential allergic and toxic complications of radiocontrast media.

• #95 Hydronephrosis: Causes, Symptoms, Treatment, Diagnosis and More

  https://www.medicinenet.com/hydronephrosis/article.htm

  How do doctors diagnose hydronephrosis? The diagnosis begins with taking a history of the symptoms that the patient experiences. The health care practitioner will ask questions that will direct whether further tests need to be ordered. Reviewing the patient’s past medical history and family history may be helpful. […] The following laboratory tests may be ordered depending on what potential diagnosis is being considered. Urinalysis to look for blood, infection, or abnormal cells. A complete blood count (CBC) may reveal anemia or potential infection. Electrolyte analysis may be helpful in chronic hydronephrosis since the kidneys are responsible for maintaining and balancing their concentrations in the bloodstream. BUN (blood urea nitrogen), creatinine, and glomerular filtration rate (GFR) are blood tests that help assess kidney function.

• #96 Hydronephrosis: Understanding Causes, Diagnosis and Treatment

  https://www.instituteofurology.in/hydronephrosis-understanding-causes-diagnosis-and-treatment/

  Hydronephrosis occurs when urine cannot drain out from the kidney to the bladder due to a blockage or obstruction, leading to kidney swelling. […] A comprehensive medical history and physical examination are the first steps in diagnosing hydronephrosis. The healthcare provider will ask about symptoms, medical conditions, and any history of kidney stones or UTIs. […] Ultrasound: The primary imaging modality for diagnosing hydronephrosis. It helps assess kidney size, urinary tract obstruction, and the presence of stones. […] CT Scan: Provides detailed images of the urinary tract, useful for identifying the cause and extent of obstruction. […] MRI: An alternative imaging option, particularly useful in children and pregnant women. […] Intravenous Pyelogram (IVP): An X-ray exam using contrast dye to visualize the urinary tract.

• #97 Hydronephrosis and Hydroureter – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK563217/

  The cause of urinary obstruction can be broadly classified as intrinsic and extrinsic compression. […] Nephrolithiasis is the most common cause of hydroureteronephrosis in young adults. […] Hydronephrosis is commonly seen in up to 80% of pregnant women. […] The obstruction of the outward flow of urine leads to an increase in the hydrostatic pressure of the collecting system. […] If the obstruction is not relieved, it can lead to kidney scarring and permanent kidney damage with the compromise of glomerular and tubular function. […] The overall prognosis of renal recovery after the obstruction is relieved depends on the duration and severity of obstruction. […] Urinary tract infection is the most common complication of hydronephrosis. […] Patients should be educated to seek care promptly when they have these symptoms. […] Hydronephrosis and hydroureter are frequently encountered in all age groups, and all types of practices and are best managed with an interprofessional team approach. […] The involvement of nephrologists and urologists early in the diagnosis will improve outcomes.

• #98 Role of Point-of-Care Ultrasound (POCUS) in Grading of Hydronephrosis – A Simple Approach – Point-of-Care Ultrasound Certification Academy

  https://www.pocus.org/role-of-pocus-in-grading-hydronephrosis-a-simple-approach/

  The patient may not fully understand the implications of the severity of hydronephrosis. Therefore, once we diagnose moderate or severe hydronephrosis it is the duty of the clinician to make sure that the concern is addressed appropriately. There have been instances when a patient presented with moderate hydronephrosis and then the patient did not follow up for few years. When the patient was seen after a few years, a diagnosis of severe hydronephrosis was made with complete destruction of the renal parenchyma and the patient had to undergo nephrectomy. This bad outcome was avoidable.

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