Hydronephrosis

Question 1

What is hydronephrosis?

Answer 1

condition where one or both kidneys become stretched and swollen as a result of a build-up of urine inside them.

Question 2

What are the unilateral causes of hydronephrosis? mneumonic PACT

Answer 2

Pelvic-ureteric obstruction
Aberrant renal vessels
Calculi
Tumours of the renal pelvis

Question 3

What are the bilateral causes of hydronephrosis? meumonic SUPER

Answer 3

Stenosis of the urethrea
Urethral valve incompetance)
Prostatic enlargement
Extensive bladder tumour
Retro-peritoneal fibrosis

Question 4

What investigations should be done for hydronephrosis?

Answer 4

• 1st USS
• IV urogram
• Antegrade or retrograde pyelography -allows treatment
• CT scan if suspect stones

Question 5

What is the management of hydronephrosis?

Answer 5

• Remove obstruction and drainage of urine
• Acute upper urinary tract obstruction: nephrostomy tube
• Chronic upper urinary tract obstruction = ureteric stent or pyeloplasty