All about hydronephrosis: what happens if you miss a violation of the outflow of urine

Urologist

Mkrtchyan

Karen Gagikovich

14 years of experience

Candidate of Medical Sciences, member of the European Association of Urology and the Russian Society of Oncourologists

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Hydronephrosis is a disease during which the expansion of the pyelocaliceal complex actively progresses. Due to this progression, atrophy of the renal parenchyma may subsequently begin. This consequence develops due to the fact that the stable functioning of the outflow of urine from the kidney is disrupted. Often it makes itself felt, causing severe pain in the lumbar region or painful urination. With hydronephrosis, a pathology such as arterial hypertension can also begin, which can lead to further negative consequences.

At the first pain during urination, it is best to go to the hospital and see a professional doctor so that the disease does not turn out to be advanced. If we look at the diagnosis of hydronephrosis in general, it is often an ultrasound, which is used to check the functioning of the bladder and the functioning of a person’s kidneys. It is possible to cure hydronephrosis, but for this there is a special method - nephrostomy, which will be discussed in more detail later.

In general, hydronephrosis refers to a change in the kidney that occurs due to the fact that the physiological passage of urine is disrupted. As a result, due to such serious disorders, a disease such as hydronephrosis occurs. The cavities of the kidneys begin to rapidly expand pathologically, and the kidney tissue is also subject to changes.

It is worth noting that women often suffer most from the occurrence of this disease. Basically, the disease occurs in adults aged twenty to sixty years. After sixty, the disease can begin to develop in an adult man due to the prostate or prostate cancer. As for women, they suffer from hydronephrosis during pregnancy or due to the development of gynecological cancer.

Nowadays, it is more than possible to treat renal hydronephrosis, especially if you use modern treatment methods, but for this you need to go to a specialized clinic. Using home methods for treating kidney hydronephrosis can only worsen the whole situation. The fact is that hydronephrosis has many stages and a large number of symptoms, which can only be identified by diagnosis.

Modern classification of hydronephrosis

In general, hydronephrosis is divided into:

• primary;
• acquired.

In the first case, this is a congenital disease, which is transmitted to a person genetically, in the second, it is acquired - this is a dynamic method.

Based on the severity of the disease, there is the following classification of hydronephrosis:

• easy;
• moderate;
• heavy.

If we talk about the localization of the disease, it happens:

• unilateral;
• double-sided

It is important to note here that doctors working in the field of urology quite often note that both women and men experience hydronephrosis of both the left and right kidneys, and in some cases, bilateral changes in the human kidneys occur simultaneously.

Hydronephrosis can occur in both acute and chronic forms. The acute form is quite simple and quick to cure using modern techniques. If the form of the disease is chronic, then the kidneys may stop functioning forever even with the best treatment. The disease can develop infected or aseptically.

Hydronephrosis can cause some complications if you turn a blind eye to the fact that a person suffers from similar bladder-related diseases. Due to chronic hydronephrosis, in many cases the first thing that may begin to develop is urolithiasis and pyelonephritis. These diseases have an even more adverse effect on kidney function.

Due to hydronephrosis, kidney failure may begin to appear, especially if both kidneys are affected by the disease, this can lead to death. At any moment, due to impaired water balance or food intoxication, the diseased kidney or both kidneys may fail. The life of a patient with one of these diseases associated with problems with the human bladder can be cut short by a rupture of the sac inside the body. Then urine can spill into the retroperitoneal space and cause critical harm to the entire human body.

The special science of urology and ultrasound can understand that a person is developing hydronephrosis and prevent pathology. A professional doctor will always be able to predict whether a person’s kidney function is in perfect order or what threatens him, so it is best to have it checked periodically at a medical center. It is possible to effectively treat bladder disease if you do not get down to business when it is too late and provide first aid.

What happens to the kidney when the outflow of urine is disrupted?

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The blood is constantly filtered through the kidneys, forming urine, and this work stops only in critical conditions with an abnormal drop in blood pressure. If the produced urine has nowhere to go, the kidneys become enlarged and stretched. An increase in kidney size is one of the standard signs of hydronephrosis. All parts of this organ are stretched, but especially the elastic pelvis and calyx. In extreme cases, the pelvis can even rupture, spilling its entire contents into the abdominal cavity.

In stagnant urine, bacteria find a nutrient medium, and complications begin in the form of infection and suppuration. Salts of acids contained in urine, with prolonged stagnation of urine, can precipitate and form stones, which further worsens the situation.

In an enlarged kidney, the nephrons or structural units of the kidney tissue are affected. This leads to a decrease in the filtration function of the kidney. In urine tests, urea and creatinine levels increase, and electrolyte imbalance increases. The acid-base balance or pH of urine and blood changes. Such changes in homeostasis affect the entire body, and severe intoxication can develop.

Knowing the severe consequences of hydronephrosis, CELT doctors strive to eliminate the obstruction to the outflow of urine as early as possible in order to preserve kidney function.

Symptoms, signs of hydronephrosis

It is generally accepted that hydronephrosis manifests itself in a person with various symptoms, since it depends on the location of the hydronephrosis and how quickly the disease associated with the bladder develops. The severity of the disease and the manifestation of symptoms are related to how long the kidney disease lasts. The degree of kidney expansion actively influences the manifestation of the disease. It is important to note that the acute form of hydronephrosis develops quite rapidly and portends a negative outcome if treatment is not started.

During an acute exacerbation, pain in the lumbar region periodically begins to appear in the form of increasing daily attacks. This symptom should make you think about going to the doctor. True symptoms of the disease may also include renal failure, frequent renal colic that spreads through the ureter. Thus, clogging of the urinary canals quickly occurs, which is noted by the science of urology. Colic can spread to the thighs, groin area, perineum or genitals, then both women and men will periodically feel pain in these parts of the body.

List of common symptoms of hydronephrosis:

• frequent urges of the body to go to the toilet and urinate;
• another sign is constant nausea after every meal;
• headache;
• fatigue, irritation;
• gagging;
• Drops of blood may appear in the urine, which can be seen both with the naked eye and by taking a test to a laboratory.

People who struggle with hydronephrosis every day often also report signs of the disease such as high blood pressure and bloating. In addition, patients often develop fever. If we talk about unilateral aseptic chronic hydronephrosis, then most of its time it develops latently. It affects the development of renal failure, pain in the urinary canals. In this case, the bladder experiences discomfort when urinating. The patient may experience constant pain not only in the lower back, but also in the ribs, and with physical activity, all pain in both kidneys intensifies even more.

If the development of hydronephrosis is not stopped, the disease can be fatal, so it is very important to pay attention to all symptoms that appear. People diagnosed with hydronephrosis of the kidneys are not advised to drink a lot of water, as due to increased water balance they may experience symptoms such as kidney pain.

In general, kidney hydronephrosis can also manifest itself as symptoms such as discomfort in the kidneys, insomnia, tingling in the lower back, chronic fatigue, low level of work ability, and hematuria. If a patient with renal hydronephrosis experiences frequent high body temperature, then most likely he is infected. If you experience such symptoms, you should immediately seek help from a doctor. If a person’s kidney is inflamed, then it is necessary to take antibiotics and other medications, but in order to avoid pain in the kidneys later, you need to consult a doctor.

An infected bladder can also manifest its symptoms with hydronephrosis of the kidney, since then the patient feels severe pain when urinating or has problems going to the toilet. It is necessary to pay attention to all the symptoms that the body gives so that there are no problems with the kidney in the future.

Doctors note that when a patient has pain in the bladder, as well as both kidneys, the patient prefers to sleep only on his stomach and cannot change positions. Such symptoms also make you think about the disease. So, to protect the kidney, a person tries to apply pressure and improve the flow of urine. Almost anyone can develop hydronephrosis in the kidney, so you should pay attention to every sign. It is possible to prevent hydronephrosis if you find the cause of the disease and use modern treatment methods. It is worth monitoring your kidneys and doing the necessary tests to check their condition.

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How does the disease manifest itself?

The main symptom of renal hydronephrosis is aching pain in the lower back. It occurs on the side of a damaged kidney, sometimes taking on the character of renal colic. Hydronephrosis of the right kidney (more precisely, hydronephrosis on the right) often occurs without symptoms for a long time, which is why it can only be detected by the results of laboratory tests. As the disease progresses, other symptoms appear:

• nausea,
• weakness,
• temperature,
• dull moderate pain on the right (similar to appendicitis and renal colic),
• blood in urine
• decrease in daily urine volume,
• high blood pressure.

Hydronephrosis of the left kidney (more correctly - hydronephrosis on the left) causes dull aching pain on the left. Sometimes they are burning and acute, even unbearable, because of which a person cannot find a place for himself. Other signs of renal hydronephrosis on the left are the same as on the right. The most dangerous sign is considered to be an increase in temperature, as this indicates infection has entered the organ.

Diagnosis of hydronephrosis

To determine whether a person is suffering from kidney pain, he needs to undergo a special diagnosis before directly starting treatment. First, the doctor needs to collect all the data about the patient and, based on already known information, conduct a physical examination. This method is considered one of the most proven in the field of diagnosis if it is noted that the kidney is in danger and treatment is needed. After the patient successfully passes the physical examination, he will undergo a series of special laboratory tests, as well as some instrumental studies. Typically, all these methods are used in modern diagnostics. To establish an accurate diagnosis for treatment, if the patient has a damaged kidney, professionals at the clinic can perform deep palpation of the abdomen. This determines how stretched the bladder is in an adult or child and whether the kidney is enlarged.

If the patient complains that he periodically feels colic in the abdominal area, then the diagnosis allows catheterization of the bladder. In most cases, many clinics resort to a proven diagnostic method - ultrasound. This is a comprehensive approach by the doctor to understand what he is dealing with; sometimes X-ray contrast studies are also used. Using an x-ray, you can easily determine how the excretory function works with an active kidney.

To check the kidney even more effectively and accurately, doctors resort to urethroscopy and nephroscopy before prescribing direct treatment for the patient. In addition, blood and urine are constantly tested so that the doctor can monitor changes in biochemical parameters.

Why hydronephrosis is dangerous: a real story that ended badly

The content of the article

“I was sent to you, apparently by mistake. Please look at the urine tests and the results of the ultrasound of the kidneys,” said one of our patients.

Changes in the urine of this patient made us wary: a very important function of the kidneys, their ability to concentrate urine, had weakened, and pus had appeared in it. The kidneys began to remove less salts and urea from the body.

The patient recalled that she had pain in the lumbar region, unexpected, unexplained increases in temperature, and chills. Believing that this was how the flu began, she took medication at her own discretion and after two or three days she felt better.

But time passed, and the disturbing symptoms appeared again. Examination of the patient in the urology department of the hospital gave a disappointing result; She was diagnosed with right-sided hydronephrosis. The name of the disease comes from two Greek words “hydor” - water and “neph-ros” - kidney.

The disease is characterized by persistent expansion of the renal pelvis due to stagnation of urine in it. Stagnation is possible for various reasons, and one of them is narrowing of the ureter. Such a defect was also found in our patient. She was offered surgical treatment, but, feeling better during her stay in the hospital, she refused the operation.

Three years later, this patient was taken to the surgical department by ambulance. When the doctor asked what was bothering her, she replied: “Pain in the abdomen on the right, vomiting, high temperature.”

After the examination, a diagnosis was made: right-sided infected hydronephrosis with complete dysfunction of the right kidney, purulent inflammation of its cavities.

This time, surgery became inevitable, and the patient's right kidney was removed. If three years ago this woman had believed the doctor that timely surgery would help stop the painful process, the kidney would not have had to be removed.

Causes of hydronephrosis

All doctors name different causes of hydronephrosis, since this disease can occur differently in each person. One of the most common causes of hydronephrosis is the separation of the ureter from the renal pelvis. This happens even in childhood, when the entire structure of organs is disrupted. Another cause of the disease may be a tumor, which in this case should be located at the same level with the ureter and at the same time constantly press on it. Also, the obvious cause of the disease is a fungus, which, if hygiene standards are not followed, can affect the urinary tract.

Doctors actively highlight such a reason as pregnancy in women. Almost every woman on the planet, being pregnant, has suffered from this disease at least once. The obvious causes of the disease are gynecological diseases, since one problem immediately causes another.

Prostate disease in men can cause not only the development of prostatitis, but also hydronephrosis, which will affect and undermine the health of one or two kidneys. Another cause known to many is bladder disease, and there are more than enough variations: from a tumor to an injury.

Disease severity

Hydronephrosis is divided into four degrees of severity:

• I degree. The initial process of pathology, when there is a violation of the outflow of urine and due to stretching of the maxillary joint. At the same time, the walls of the cups and pelvis retain their elasticity and ability to contract. Pathological changes in the first stage are reversible.
• II degree. Prolonged difficulty in the outflow of urine, in which the walls of the calyces and pelvis gradually lose their elasticity, slight changes appear in the renal tubules and nitrogenous wastes in the blood increase.
• III degree. The patient experiences a disruption of the normal anatomy of the maxillofacial joint, the kidney increases in size, and the parenchyma gradually atrophies. The organ begins to appear as a formation filled with urine, which still retains its functions. Nitrogen wastes increase, so kidney failure progresses. Hydronephrosis grade 3 can cause fatigue, weakness, and increased blood pressure.
• IV degree. The kidney increases significantly in size, and the natural anatomy and functionality are completely disrupted. The kidney tissue is mostly replaced by coarse connective tissue. The organ is a thin-walled bladder filled with urine. In case of grade 4 hydronephrosis, it is completely removed.

Diagnostic methods

When the first symptoms of urinary outflow disturbance or pain occur, it is necessary to be examined.

1. The pathology is diagnosed using an ultrasound of the kidneys, which allows you to see the expansion of the organ and structures that impede the normal outflow of urine.
2. One of the most informative methods is computed tomography, which helps to obtain layer-by-layer sections and a three-dimensional image of the organ and the pyelocaliceal complex. When the kidney is enlarged and fluid accumulates, it is easy to diagnose hydronephrosis.
3. For diagnosis, a radioisotope research method is also used - nephroscintigraphy. A radioactive drug is injected into the patient's body, after which it is placed in a gamma chamber to assess the distribution of the drug in the tissues of the urinary system. The method allows you to assess the degree of pathology and determine treatment tactics.

Treatment of hydronephrosis

Hydronephrosis can be cured using various methods. It is only important to find the right individual approach to each patient and prescribe a suitable course of treatment. If you decide on a set of medications, exercises and techniques, you can not only bring the kidney back to life, but also improve its function. The entire course of treatment has several goals - to eliminate all the causes of the development of hydronephrosis, put the human body in order and provide a professional, proper course of treatment. Mostly doctors use conservative or surgical treatment.

As for the first option, this treatment is used only in the first stages of the disease and is rather symptomatic. During this process, doctors use various drugs to relieve pain, inflammation, and fever. If an infection is detected during a diagnostic study, conservative treatment allows the use of antibiotics. If this course does not help, then surgery follows, but taking medications is a mandatory step in the treatment of hydronephrosis.

Very often, surgery is necessary for the patient to fully recover. Then the second part of the treatment course occurs - surgical intervention. It is recommended not to delay and to perform surgery in the early stages of the disease, especially if the patient has been diagnosed with a congenital anomaly.

Stages of development (degrees) of renal hydronephrosis

Based on the time of development, the following types of pathology are distinguished:

1. Primary (congenital). Develops during fetal development and is the result of pathology of the upper urinary tract
2. Secondary (acquired). Usually the disease is a complication of another pathology (tumor process, kidney stones, etc.)

Depending on the location, there are:

• Unilateral hydronephrosis. It develops in one kidney
• Bilateral. The pathological process occurs in both organs

There are several stages of hydronephrosis:

1. Initial. It is characterized by dilation of the pelvis and minor (unexpressed) dysfunction of organs
2. Stage of pronounced manifestations. At this stage, not only the pelvis, but also the calyx expands. At the same time, the parenchyma becomes thinner. Kidney function is significantly impaired
3. Terminal. At this stage, parenchymal atrophy occurs. The kidney turns into a thin-walled sac and cannot perform its functions

Important! You need to see a doctor as soon as possible. This will allow for the necessary diagnosis and treatment of hydronephrosis of the left or right kidney with maximum efficiency.

Doctors treating this disease

As explained above, the field of medicine known as urology deals with the treatment and study of hydronephrosis in detail and professionally. But it is not the urologist who directly deals with the treatment, but the nephrologist. The fact is that for the most part, patients are not dealing with a bladder problem, but directly with poor kidney function. It is the nephrologist who professionally studies such an organ of the human body as the kidneys. A nephrologist diagnoses the disease, gives his recommendations, prescribes prevention of kidney disease and personally carries out treatment, if it concerns his area.

It cannot be said that only a nephrologist can cope with a pathology such as hydronephrosis, since initially the patient visits a general practitioner. In most cases, after the initial appointment, the therapist refers the client to an endocrinologist so that he can make his professional conclusions. If suspicions of a disease are justified, then the person goes to see a urologist and after that a nephrologist begins to deal with his disease.

At JSC “Medicine” (academician Roitberg’s clinic), every patient receives due attention and care, and this applies not only to the medical staff. Each patient will have his own attending physician who deals with his disease, so the list of doctors at the clinic is very large. There is always the opportunity to choose the doctor who is more attractive or has professional skills, for example, in the case of hydronephrosis.

Diet for kidney disease

Both before and after the operation, the patient needs to follow a diet, thereby preventing the possibility of the formation of new stones.

• People who have, for example, urate (uric acid) stones removed, need to reduce their intake of meat and fish dishes.
• If there were oxalate (oxalic acid) stones, then the consumption of chocolate, cocoa, and strong coffee is prohibited.
• Those patients in whom phosphate stones are discovered or removed must reduce their diet from dishes with vegetable oils and dairy products.

With this disease, doctors often recommend mineral waters, which enhance the contraction of the muscles of the urinary tract, thereby eliminating stagnation of urine. What mineral water to drink, in what quantity, and at what time, is decided in each specific case by the attending physician.

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Indications

In order for the disease to disappear faster, many doctors highlight the following indications: it is necessary to visit a urologist annually to identify possible pathologies at an early stage; ultrasound of the kidneys is a mandatory indication. It is ultrasound that can provide accurate data about what is happening with the kidneys in the human body. It is best to periodically carry out the prevention of bladder disease.

In addition, people should not forget about maintaining a healthy lifestyle and proper nutrition. All this is interconnected, since due to a large amount of salty, fatty foods and alcohol, not only the liver, but also the kidneys suffer. If a person does not monitor his health, then it is quite possible that already in his youth he will begin to suffer from pathologies.

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Contraindications

With hydronephrosis, doctors also identify some contraindications that should not be forgotten, since the effectiveness of the patient’s treatment depends on this.

There are the following contraindications for hydronephrosis:

• the patient should not engage in strenuous sports or physically exert himself at all;
• It is better not to ride a horse, ride a bicycle or motorcycle;
• in no case should you engage in self-medication and traditional medicine;
• without a doctor’s prescription, you cannot reduce or increase the dose of painkillers, antipyretics, or anti-inflammatory medications;
• You should give up junk food and go on a special diet, because everything fatty, salty, and spicy is contraindicated.

Cost of initial appointment, research, treatment

It is impossible to name the exact cost of the entire course of treatment for hydronephrosis in the clinic or the initial diagnosis. All this depends on which specialist will work with the patient, as well as what techniques will be used during recovery. The medical center primarily uses only modern innovative equipment. The same applies to medications that speed up the process of recovery. Consequently, even the initial appointment is individual for each client, which is why the price will be different. To have at least the slightest idea of ​​how much treatment at the clinic will cost, you can familiarize yourself with the pricing table.

Advantages of treatment at the clinic of JSC "Medicine"

Clinic JSC "Medicine" is a professional medical center that provides services at the highest global level. Each patient will receive effective treatment, constant care and attention from the medical staff. In addition, the clinic employs professionals with many years of experience who will never make even the slightest mistake. You can trust our clinic with your health. Every new patient can expect modern, clean rooms, good nutrition and the best innovative equipment that can quickly get you back on your feet.