How to Treat Hydronephrosis

Hydronephrosis is a condition of swelling of one or both kidneys caused by urine that accumulates and cannot flow to the bladder. This condition can be experienced by anyone regardless of age, even in the fetus can occur which is called antenatal hydronephrosis. Then how to treat hydronephrosis? Read an explanation of the causes, symptoms, treatment and prevention here.

If hydronephrosis can be detected and treated quickly, it rarely causes long-term complications. Conversely, if left untreated, hydronephrosis is at risk of causing infection and scarring in the kidneys which can lead to kidney failure problems.

The treatment for hydronephrosis aims to treat medical conditions that cause obstructed urine flow. Hydronephrosis treatment method can be with medication or surgical procedures.

Causes of Hydronephrosis

Kidneys have various important functions, namely to filter out excess water, salt, and metabolic waste. The rest of the filtering will then be excreted through the urine. However, if there is a blockage in the urinary tract (ureter), the urine that should be excreted will accumulate in the kidneys. This condition can cause the kidneys to swell (hydronephrosis).

Hydronephrosis can also be caused by certain medical conditions or diseases suffered by the patient. Some conditions or diseases that can cause hydronephrosis are:

• Kidney stones that come out of the kidney and block the ureter
• Formation of blood clots in the ureters or kidneys
• The growth of cancer or tumors around the bladder, urinary tract, pelvis, or abdomen
• Vesicoureteral reflux (VUR) is a condition when urine from the bladder backs up into the kidneys, it can occur due to an enlarged prostate, narrowing of the urinary tract (urethra), or congenital abnormalities
• The appearance of scar tissue due to infection, radiotherapy, or surgery that can cause narrowing of the ureter
• Disorders of the nerves or muscles of the bladder
• Uterine prolapse or descent
• Urinary retention
• Pregnancy

Meanwhile, the causes of hydronephrosis in infants are usually found on prenatal ultrasound examinations.

The causes of hydronephrosis in infants are:

• Blockage (obstruction) that can prevent urine from flowing out of the kidney
• Birth defects such as spina bifida, branching ureters (ectopic ureters) or urethral valve abnormalities (posterior urethral valves)
• Uretocele is the formation of a sac in the ureter that can block the ureter
• Bladder muscle disorders occur which can cause urine to flow back into the kidneys

In certain cases of hydronephrosis, it is not known what causes hydronephrosis in infants. For babies before birth who experience hydronephrosis generally can heal by itself after the baby is born. While mild hydronephrosis that occurs in children usually does not affect kidney function and within a certain time can heal.

Symptoms of Hydronephrosis

In certain hydronephrosis there are no symptoms. While certain hydronephrosis sufferers also experience some symptoms. The symptoms that can be felt by patients with hydronephrosis are as follows:

• Pain in the back and pelvis that can radiate to the lower abdomen or groin
• Pain when urinating (dysuria)
• Rarely urinate
• Hematuria
• Nausea and vomiting
• Fatigue or malaise
• Symptoms of a urinary tract infection are characterized by weak urine flow, dark urine, burning sensation when passing urine, chills, and fever
• Unable to empty bladder completely

Usually hydronephrosis that occurs in newborns does not cause symptoms, but it can also cause an enlarged abdomen or symptoms of a urinary tract infection, such as fever, refusal to breastfeed and fussiness. While the symptoms of hydronephrosis in children include low back or abdominal pain, bedwetting, nausea, vomiting, fever, and impaired growth and development.

How to Treat Hydronephrosis of Kidney

If symptoms of hydronephrosis appear accompanied by signs of urinary tract infections, decreased urine production (oliguria), and fever, then immediately check with a doctor. The doctor will ask about the symptoms experienced as well as the patient's and family's medical history. After that, the doctor will perform a physical examination by touching, tapping and pressing the back of the patient's waist slowly.

After that, to confirm the diagnosis, the doctor will perform several supporting examinations, such as:

• Urine test, to see the presence of blood, bacterial infection and crystal stones in the urine
• Blood tests, to detect infection and also check kidney function
• Intravenous urography, to see the condition of the urinary tract through the help of contrast agents and X-rays
• Scanning with a CT scan or ultrasound, to see a more detailed picture of the kidneys

The method used to treat hydronephrosis will depend on the cause and severity. In mild and moderate hydronephrosis, sometimes the treatment is enough with antibiotics to prevent infection in the urinary tract.

As for some of the treatment methods to treat hydronephrosis are as follows:

1. Catheterization

If hydronephrosis is due to a blockage in the ureter, the doctor may place a catheter to drain urine into the bladder. In addition, doctors can also install a nephrostomy channel to drain urine from the kidneys to the outside of the body directly.

2. Giving medicine

Doctors can give antibiotics and pain relievers to relieve pain from a urinary tract infection (UTI).

3. Surgery

Surgery is performed to treat hydronephrosis caused by an enlarged prostate or kidney stones. This surgical procedure is also performed if the urinary tract is blocked by a blood clot or scar tissue.

In patients with hydronephrosis caused by cancer, doctors may perform surgery combined with radiotherapy or chemotherapy.

How to Treat Mild Hydronephrosis in Pregnancy

Hydronephrosis in pregnant women generally does not require special treatment, because it can improve within a few weeks after delivery.

How to Treat Hydronephrosis in Fetus and Babies

How to treat fetal hydronephrosis? Generally, fetuses diagnosed with hydronephrosis in the womb do not require special treatment. This is because hydronephrosis can improve on its own before the fetus is born, or it can heal on its own within a few months after the fetus is born.

However, it is still necessary to have a scan for several weeks after delivery to prevent complications. How to treat hydronephrosis in babies if hydronephrosis does not improve on its own, the doctor will prescribe antibiotics or if necessary, the doctor may perform a surgical procedure.

Complications of Hydronephrosis

Hydronephrosis that is not treated immediately can cause increased pressure on the kidneys. This condition can reduce the ability of the kidneys to filter blood and remove waste, and can cause electrolyte balance disorders in the body. In addition, hydronephrosis can also cause other complications, namely kidney infection. In certain cases, kidney infection can cause permanent kidney damage which can lead to kidney failure.

How to Prevent Hydronephrosis

How to prevent hydronephrosis can be by living a healthy lifestyle, avoiding the causes, and immediately undergoing treatment if you suffer from diseases that can cause hydronephrosis.

For those who have a history of kidney stones, how to prevent them can be by undergoing a special diet, maintaining body fluids, and avoiding risk factors that can cause recurrent kidney stones. For more, please read: How to Treat and Prevent Kidney Stones.

That's the explanation that we can write about how to treat hydronephrosis, hopefully it can be useful.