In broad terms, hydronephrosis is a radiology term defining fluid buildup inside the kidney. The kidneys filter toxins and excess liquid from the blood to produce urine. Generally, urine is excreted from the kidney down the urine tube (ureter) and into the bladder. Under normal conditions, the urine carries the kidney regularly. Still, if something like the narrowing of the ureter takes place or backflow of the urine, or kidney stone creates a delay in the outflow of urine from the kidney, then the kidney can grow more swollen with fluid than normal. In many circumstances, hydronephrosis happens in normally-functioning kidneys but some problems are connected with unusual or poorly-functioning kidneys or other genetic ailments.
How Is Hydronephrosis Diagnosed?
In many of the younger babies after birth, hydronephrosis, even when severe, often does not show any noticeable symptoms. There are even cases where babies or children might develop symptoms such as a urinary tract infection, blood in the urine, excessive fussiness, unexplained flank or abdominal pain. In such cases the doctor may order an abdominal or kidney/bladder ultrasound or occasionally a CT scan which will detect kidney swelling. The greater the grade of hydronephrosis, the more likely that the child will have signs. Some sufferers with notable hydronephrosis may not possess symptoms, particularly if the swelling happened slowly over time.
The Suggested Test For Hydronephrosis
The most valuable information about the shape and size of the bladder, the bladder neck (or opening) and the tubes that drain the urine from the kidneys into the bladder, designated as the ureters can be diagnosed with Voiding cystourethrogram test. It allows diagnosing reflux or the unusual back-flow of urine from the bladder into the ureter and up to the kidney. It also contributes extra-anatomic knowledge about the urethra to make sure no blockage is present (posterior urethral valves).
Kidney (Renal) Scan: This examination may be done depending on the records of urinary tract infection(s), the result of VCUG, or the sharpness of the hydronephrosis. It is utilized to better demonstrate the actual function or drainage of the kidneys. A kidney scan can also reveal if there is kidney damage and/or scarring that may have emerged from a previous urinary tract infection or long-standing hydronephrosis.
Why Does The Kidney Swell In These Cases?
Hydronephrosis is like a resistance mechanism for the kidney when urine is sluggish to drain. The stretching of the kidney concedes the backpressure of urine to be more uniformly distributed. This may assist to limit or slow down some of the possible damage to the kidney from urine stiffening up abnormally.
Can Hydronephrosis Get Healed On Its Own?
Indeed, the More youthful children with milder forms of inflammation who are not possessing signs can often sustain kidney function. The chief care doctor or a pediatric kidney specialist, like a nephrologist or urologist, can observe the extent of swelling by purchasing a kidney ultrasound every few months as they view relevant.
In many circumstances, but not all, the hydronephrosis may grow as its cause repairs, particularly in young babies as they grow over time. Additional examination such as a cystogram wherein the bladder catheter examination is done to look for abnormal urine reflux from the bladder into the ureter or a nuclear medicine renal scan to assess kidney function and drainage may be required along with ultrasounds to help define the course of the hydronephrosis.
When Do Children With Hydronephrosis Need Surgery?
Hydronephrosis can produce different symptoms like flank pain or vomiting or can be damaging to the health of the kidney over time. Doctors must discover the cause of the inflammation and whether it is something that may develop on its own. If it looks to be worsening, a restorative method may be required. For instance, kidney stones that become stuck in the ureter as they try to pass can cause temporary blockage of the urine flow and hydronephrosis in earlier fit patients.
One of the leading Urologist in Delhi Dr. Ashish Saini at Excel Advance Urology Centre has extensive experience with hydronephrosis. Based on how much the kidney is stretched and up to what extent urinary flow is impaired Dr. Saini will tell you whether your child’s hydronephrosis affects one kidney or both the kidneys