Pee not flowing freely?|Water in Kidney | Swollen

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Dr. Girish Nelivigi | Phone 📞 : +91 70222 09038 / 08048668768 (Online & in-person appointment can be booked online or by call) Consultant Urologist and Andrologist | Nelivigi Multispeciality Hospital, Bengaluru, India
Today I'll be talking of a condition called Hydronephrosis. Hydronephrosis is nothing but water in the kidneys or swelling of the kidneys. A patient does not come to the doctor with hydronephrosis. Hydronephrosis is a diagnosis which is made on ultrasound of the abdomen or on CT scan the radiologist or the sonologists usually writes hydronephrosis seen either in the right kidney or in the left kidney or in both the kidneys. Once the patient comes the urologist will have to evaluate the causes for hydronephrosis. Many times if the hydronephrosis is mild or the swelling of the kidneys is mild it is called a physiological hydronephrosis which means it is normal. By emptying the bladder the hydronephrosis disappears. However there are situations where the hydronephrosis is part of a disease now what causes hydronephrosis. In such situations it could be some blockage to the outlet of the bladder as happens in enlargement of the prostate in elderly people. It can also be due to a condition called stricture of the urethra which is narrowing of the urinary passage which leads to stasis of urinary in the urinary bladder and back pressure causing hydronephrosis. But a most common cause for hydronephrosis is because of stones.. Stones cause a blockage in the urine or in the kidney itself and this causes swelling of the kidney or the urethra. So when there is a swelling of the kidney and the urethra it is called Hydronephrosis. When there is only swelling of the kidney it is called hydronephrosis. So as I said stones are the most common cause for swelling of the kidney there are other causes for hydronephrosis also like PUJ obstruction or some other congenital abnormalities. But they are not that common therefore when you see a report of hydronephrosis most often it is because of blockage because of stones or some blockage at the outlet because of prostate what is the evaluation and treatment for hydronephrosis usually hydronephrosis evaluation. The main stay is by ultrasound of the abdomen. This will detect and also find the cause for a huge majority of the causes for hydronephrosis only one if the ultrasound is not conclusive. Then we do a CT scan the CT scan, could be plain CT scan or sometimes when the plain CT scan does not give the information. We do a contrast CT scan which is injection of a contrast in the vein and doing a CT scan. So I enumerated the causes for hydronephrosis which are stone enlargement of the prostate some condition like stricture of the urethra or PUJ obstruction etc. Now depending on what we find on ultrasound and CT scan the treatment will be given. For example prostate is causing hydronephrosis then that has to be treated. If stones are the causes for hydronephrosis they have to be treated if it is because of PUJ obstruction then we don't always treat but we do further evaluation to see if that swelling is affecting the kidney function and depending on that the treatment is prescribed. So depending on the causes for hydronephrosis the treatment is decided.



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