Hydronephrosis is swelling of the kidneys due to a buildup of urine, in which urine cannot flow from the kidneys to the bladder. This condition generally occurs in one kidney, but it is possible to occur in both kidneys at once. This disease is not a primary disease, but is a secondary condition of other diseases that develop in the body.
If detected and treated promptly, hydronephrosis rarely causes long-term complications. However, if left untreated, kidney swelling has the potential to cause urinary tract infections and scarring of the kidneys, leading to kidney failure.
This condition can be experienced by people of all ages, even in the developing fetus in the womb (antenatal hydronephrosis). Handling is done to remove those that block the flow of urine, either by administering drugs or surgical procedures.
Symptoms of Hydronephrosis
Hydronephrosis can develop suddenly or slowly. Mild symptoms can include frequent urination and increased urge to urinate.
A number of other symptoms that accompany kidney swelling or hydronephrosis are:
- Pain in the abdomen and pelvis.
- Nauseous.
- Throw up.
- Unable to empty bladder completely.
- Pain when urinating or urinating (dysuria).
- Hematuria.
- Urination is less frequent, or urine comes out with a weak stream.
- Symptoms of a urinary tract infection, with signs of dark urine, weak urine flow, chills, fever, or a burning feeling when passing urine.
Hydronephrosis in infants usually does not cause symptoms, but signs of urinary tract infections, such as fever for no apparent reason, should be suspected as symptoms of hydronephrosis. Some cases of hydronephrosis in adults also show no symptoms at all.
Causes of Hydronephrosis
This kidney swelling is the result of another disease suffered by the patient. Hydronephrosis occurs when there is an obstruction or blockage in the urinary tract, so that urine is trapped in the kidney because it cannot be expelled. This buildup will cause swelling of the kidneys or hydronephrosis.
Some conditions that can cause blockage of the flow of urine to make the kidneys swell are:
- Pregnancy. The enlargement of the uterus during pregnancy can sometimes put pressure on the ureters or tubes that connect the kidneys to the bladder.
- Kidney stones that have the potential to block the ureter.
- Narrowing of the ureter due to the formation of scar tissue due to infection, surgery, or therapy.
- The flow of urine back from the bladder into the kidneys (vesicoureteal reflux) or the tube that connects the bladder to the urinary opening.
- Various types of cancer or tumors that occur around the urinary tract, bladder, pelvis, or abdomen.
- Disorders or damage to the nerves of the bladder or bladder neurogenic bladder.
- Pelvic organs protruding from the vagina (prolapse).
Diagnosis of Hydronephrosis
At the initial stage of the examination, the doctor will ask about the symptoms and medical history of the patient and his family. Next, the doctor can perform a physical examination, including looking at the condition of the urinary system and feeling the condition of the kidneys by gently pressing the abdomen and pelvis.
To determine the cause of hydronephrosis, a series of tests may be performed, which include:
- Blood tests, to determine the presence of infection.
- Urine test, to see the presence of blood in the urine or infection.
- Intravenous urography, to see the condition of the urinary tract by injecting a special dye in the bloodstream, which is then observed with X-rays.
- Kidney scan with ultrasound or CT scan, which can show a clear picture of the kidneys.
Hydronephrosis Treatment
Treatment of hydronephrosis aims to eliminate the blockage of urine flow, which is adjusted to the cause and severity of the patient.
Hydronephrosis that occurs in pregnant women, fetuses, or infants usually does not require treatment. In pregnant women, generally the condition will improve a few weeks after delivery. While in infants, a few months after birth. However, a scan still needs to be done to prevent the problem from continuing.
If kidney swelling is due to a blockage of the ureter, the doctor may insert a tube to dilate the ureter.stent) and drain urine into the bladder, or a nephrostomy tube that drains urine from the kidneys directly out of the body. While antibiotics and pain relievers can also be given to treat urinary tract infections.
In addition to inserting a tube or administering medication, doctors can also perform surgical procedures to treat hydronephrosis. Surgery is performed to treat kidney swelling due to kidney stones or an enlarged prostate. This procedure is also performed if there is scar tissue or a blood clot, which causes obstruction of the urinary tract. Meanwhile, for hydronephrosis due to cancer, a combined surgical procedure with chemotherapy or radiotherapy can be performed.
Complications of Hydronephrosis
Complications that can arise from hydronephrosis are kidney failure due to permanent kidney damage. This condition occurs if hydronephrosis is not treated properly. However, if one kidney can still function normally, then kidney failure is rare in cases of hydronephrosis.