Hydronephrosis overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2]
Synonyms and keywords:
Overview
Historical Perspective
Ureteral anatomy and the function of the ureterovesical junction was first discovered by Galen, Leonardo da Vinci and John Sampson.In 1950s, Hodson and Edwards was the first to discover the association between association of VUR with renal scarring.
- Ureteral anatomy and the function of the ureterovesical junction was first discovered by Galen, Leonardo da Vinci drawings and John Sampson dissections.
- In 1950s, Hodson and Edwards was the first to discover the association between association of VUR with renal scarring from bacterial infection and the development of hydronephrosis.
- In 1952, Hutch performed the first antireflux surgery in paraplegic patients.
- In 1717, the first to description of obstruction of the posterior urethra (PUO) was by Morgagni.
Classification
| Grade 0 | No renal pelvis dilation | Anteroposterior diameter of less than 4 mm in fetuses |
| Grade 1 | Mild renal pelvis dilation | Anteroposterior diameter less than 10 mm in fetuses |
| Grade 2 | Moderate renal pelvis dilation | Anteroposterior diameter between 10 and 15 mm in fetuses |
| Grade 3 | Renal pelvis dilation along with all calyces dilatation | |
| Grade 4 | Renal pelvis dilation along with all calyces dilatation
with thinning of the renal parenchyma |
Pathophysiology
Causes
Hydronephrosis is commonly caused by conditions that obstruct urine outflow anywhere between kidneys and urethral opening. It is also caused by non obstructive conditions in some cases. Most common causes of hydronephrosis are renal calculi, ureteropelvic junction obstruction, vesicoureteric reflux, carcinoma involving urinary tract, prostate enlargement and cancer, blood clots retention and external compression from pelvic and abdominal tumors such as ovarian cysts, and retroperitoneal fibrosis.
Differentiating Hydronephrosis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic study of choice | History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | X-Ray Findings | Echocardiography and Ultrasound | CT-Scan Findings | MRI Findings | Other Imaging Findings | Other Diagnostic Studies
Treatment
Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies