1. Dept. Of Urology. shanghai Renji hospital WANG YIXIN
Hydronephrosis
Dept. Of Urology. shanghai Renji hospital
WANG YIXIN

2. Etology of hydronephrosis
1.Primary hydroneprosis
intrinsic strinsic strictrue
high insertion of the ureter
PUJ
nephroptosis
extrisic compresion
renal pelvis stone or tumor

3. Etology of hydronephrosis
2.Secondary hydronephrosis
visicoureteral reflux
obstruction distal to the ureteropelvic junction:
stone, tumor, extrinsic ureteral compression,
myoneurogenic disease, ureterocele, CAB, ca of pelvic viscera
bladder outer obstruction: CAP, BPH
urethral obstruction
pregnancy

4. Pathology of hydronephrosis
1.first shows evidence of hyperactivity and hypertrophy than dilatation and atony
2.muscular loss of peristaltic activity
3.atrophy of the renal parenchyma
4.compression of the arcuate vessels ischmic atrophy

5. Symptoms and signs of hydronephrosis
1.asymptomatic (in some cases)
2.pain is felt in the renal area
3.hematuria
4.urinary infection, dysuria frequency
5.calculi
6.azotemia
7.unexplained vague GI symptoms
8.some large hydronephrosis can be palpable

6. Diagnosis of hydronephrosis
1. symptoms and signs
2. ultrasound
3. IVU
4. Cystourethralgram
5. Cystoscopy
6. RGP
7. Delayed empty
8. Isotope renography
9.urine culture

7. Treatment of hydronephrosis
1. U.T.I. Antibiotic therapy
2. Prompt drainage
3 corrected to the cause
4. Relief of lower tract obstruction
catheter drainage ,urinary diversion , indwelling pigtail ureteral catheter
5. Nephrectomy( tumor or nonfunction kidney)

8. Prognosis of hydronephrosis
Deponds on the cause ,site, duration , and
degree of kidney damage .