Bilateral hydronephrosis
Hydronephrosis - bilateralBilateral hydronephrosis is the enlargement of the parts of the kidney that collect urine. Bilateral means both sides.
Causes
Bilateral hydronephrosis occurs when urine is unable to drain from the kidney into the bladder. Hydronephrosis is not itself a disease. It occurs as a result of a problem that prevents urine from draining out of the kidneys, ureters, and bladder.
Disorders linked with bilateral hydronephrosis include:
- Acute bilateral obstructive uropathy -- sudden blockage of the kidneys
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Bladder outlet obstruction -- blockage of the bladder, which does not allow drainage
Bladder outlet obstruction
Bladder outlet obstruction (BOO) is a blockage at the base of the bladder. It reduces or stops the flow of urine into the urethra. The urethra is t...
ImageRead Article Now Book Mark Article - Chronic bilateral obstructive uropathy -- a gradual blockage of both kidneys is most often from a common singular obstruction
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Neurogenic bladder -- poorly functional bladder
Neurogenic bladder
Neurogenic bladder is a problem in which a person lacks bladder control due to a brain, spinal cord, or nerve condition.
ImageRead Article Now Book Mark Article - Posterior urethral valves -- flaps on the urethra that causes poor emptying of the bladder (in boys)
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Prune belly syndrome -- poorly emptying bladder that causes distention of the belly
Prune belly syndrome
Prune belly syndrome is a group of rare birth defects that involves these three main problems:Poor development of the abdominal muscles, causing the ...
Read Article Now Book Mark Article - Retroperitoneal fibrosis -- abnormal scar tissue that blocks the ureters
- Ureteropelvic junction obstruction -- blockage of the kidney at the point where the ureter enters the kidney
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Vesicoureteric reflux -- backup of the urine from the bladder up to the ureter or kidney
Vesicoureteric reflux
Reflux nephropathy is a condition in which the kidneys are damaged by the backward flow of urine into the kidney.
ImageRead Article Now Book Mark Article - Uterine prolapse -- when the bladder drops down and presses into the vaginal area. This causes a kink in the urethra, which prevents the urine from emptying out of the bladder.
Symptoms
In a baby, signs of a problem are often found before birth during a pregnancy ultrasound.
A urinary tract infection in a newborn baby can signal a blockage in the kidney. An older child who gets repeat urinary tract infections should also be checked for blockage.
Urinary tract infection
A urinary tract infection, or UTI, is an infection of the urinary tract. The infection can occur at different points in the urinary tract, including...
A higher than normal number of urinary tract infections is often the only symptom of the problem.
Common symptoms in adults may include:
- Back pain
- Nausea, vomiting
- Fever
- Need to urinate often
- Decreased urine output
- Blood in the urine
- Urinary incontinence
Exams and Tests
The following tests can show bilateral hydronephrosis:
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CT scan of the abdomen or kidneys
CT scan of the abdomen
An abdominal CT scan is an imaging method. This test uses x-rays to create cross-sectional pictures of the belly area. CT stands for computed tomog...
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Intravenous pyelogram (IVP), used less often
Intravenous pyelogram
An intravenous pyelogram (IVP) is a special x-ray exam of the kidneys, bladder, and ureters (the tubes that carry urine from the kidneys to the bladd...
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Pregnancy (fetal) ultrasound
Pregnancy (fetal) ultrasound
A pregnancy ultrasound is an imaging test that uses sound waves to create a picture of how a baby is developing in the womb (uterus). It is also use...
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Renal scan
Renal scan
A renal scan is a nuclear medicine exam in which a small amount of radioactive material (radioisotope) is used to measure the function of the kidneys...
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Ultrasound of the abdomen or kidneys
Ultrasound of the abdomen
Abdominal ultrasound is a type of imaging test. It is used to look at organs in the abdomen, including the liver, gallbladder, spleen, pancreas, and...
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Treatment
Placing a tube into the bladder (Foley catheter) may open the blockage. Other treatments include:
- Draining the bladder
- Relieving pressure by placing tubes in the kidney through the skin
- Placing a tube (stent) through the ureter to allow urine to flow from the kidney to bladder
The underlying cause of the blockage needs to be found and treated once the buildup of urine is relieved.
Outlook (Prognosis)
Surgery performed while the baby is in the womb or shortly after birth can have good results in improving kidney function.
Return of renal function can vary, depending on how long the blockage is present.
Possible Complications
Irreversible kidney damage may result from conditions that cause hydronephrosis.
When to Contact a Medical Professional
This problem is often found by the health care provider.
Prevention
An ultrasound during pregnancy can show a blockage in the baby's urinary tract. This allows the problem to be treated with early surgery.
Other causes of blockage, such as kidney stones, can be detected early if people notice warning signs of kidney problems.
Kidney stones
A kidney stone is a solid mass made up of tiny crystals. One or more stones can be in the kidney or ureter at the same time.
It is important to pay attention to general problems with urination.
References
Elder JS. Obstruction of the urinary tract. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 555.
Frøkiaer J. Urinary tract obstruction. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 37.
Gallagher KM, Hughes J. Urinary tract obstruction. In: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Comprehensive Clinical Nephrology. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 58.
Nakada SY, Best SL. Management of upper urinary tract obstruction. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 89.
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Female urinary tract - illustration
The female and male urinary tracts are relatively the same except for the length of the urethra.
Female urinary tract
illustration
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Male urinary tract - illustration
The male and female urinary tracts are relatively the same except for the length of the urethra.
Male urinary tract
illustration
-
Female urinary tract - illustration
The female and male urinary tracts are relatively the same except for the length of the urethra.
Female urinary tract
illustration
-
Male urinary tract - illustration
The male and female urinary tracts are relatively the same except for the length of the urethra.
Male urinary tract
illustration
Review Date: 4/1/2023
Reviewed By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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