Hydronephrosis Flashcards
What is hydronephrosis?
Swelling of the renal pelvis and calyces in the kidney
What is hydronephrosis due to?
Obstruction of the urinary tract, leading to back-pressure into the kidneys.
How can hydronephrosis present?
Unilaterally or bilaterally
What are the unlateral causes of hydronephrosis?
Pelvic-ureteric obstruction (congenital or acquired)
Aberrant renal vessels
Calculi
Tumours of renal pelvis
PACT
What are the bilateral causes of hydronephrosis?
Stenosis of the urethra
Urethral valve
Prostatic enlargement
Extensive bladder tumour
Retro-peritoneal fibrosis
SUPER
What is the first line investigation for hydronephrosis?
Ultrasound scan
What can be used to assess the position of the obstruction in the kidney?
IVU- Intravenous urogram
What investigation would you do if a renal stone was suspected?
CT
What is Idiopathic hydronephrosis the result of?
Narrowing at the pelviureteric junction (PUJ)
What can idiopathic hydronephrosis be a result of?
Congenital or develiop later in life
What are the main presenting symptoms of hydronephrosis?
Renal angle pain and a mass in the kidney area
How can idiopathic hydronephrosis be managed?
Pyeloplasty- Operation to correct the narrowing and restructure the renal pelvis
What is the initial mangement of someone presenting with hydronephrosis?
Remove the obstruction and drainage of urine
What is the management of hydronephrosis if it is causing an acute upper urinary tract obstruction?
Nephrostomy tube
What is the management of hydronephrosis if it is causing a chronic upper urinary tract obstruction?
Ureteric stent or a pyeloplasty
