Treatments for hydronephrosis vary depending on the cause and severity of each individual case. The disease is characterized by the dilation or distension of one or both of the kidneys with urine, which is caused by backward pressure on the kidneys due to a urinary obstruction. Physicians and urologists (doctors specializing in genital and urinary tract conditions), treat hydronephrosis by removing the cause of the obstruction, and also through pain control. Often the draining of the kidneys is required through the use of a catheter, and sometimes pyeloplasty may be necessary, which is the surgical reconstruction of the renal pelvis.
Hydronephrosis often is caused by an obstruction in the junction of the renal and ureter pelvis (called the ureteropelvic junction). This obstruction can result from structural abnormalities such as birth defects, kinks at the ureteropelvic junction caused by kidney shifting, stones or blood clots in the renal pelvis, and a compressed ureter caused by cancer, abnormal veins and arteries, or irregular bands of tissue. Hydronephrosis can also occur when there is an obstruction below the ureteropelvic junction, which is caused by stones or blood clots in the ureter, a narrowed ureter due to birth defects, injuries or infections, muscle or nerve disorders in the bladder or ureter, and the bulging of the lower ureter into the bladder. The disease can also be caused by pregnancy, when the swelling uterus compresses ureters.
Hydronephrosis is rated on severity from grade one to grade four. Grade one to grade three cases are usually non-obstructive and resolve on their own, while grade four cases often require surgery. In all cases, pain is often treated with the use of antibiotics. In cases where obstruction is sudden, the bladder is often drained to provide temporary relief for the patient until the exact cause of the hydrophenrosis can be discovered.
Most patients suffering form hydrophenrosis are given a prescription for antibiotics. The types of antibiotics prescribed specifically work on the urinary tract, and help prevent infections and reduce pain. They have very few side effects.
In cases of hydronephrosis where the buildup of urine within the kidneys is sudden, the immediate draining of the kidneys if often necessary. This is done through the use a catheter; a hollow rubber tube that is put into the bladder via the urethra, or is inserted directly into the kidney through an incision. It is important that affected kidneys are drained as soon as possible to prevent damage.
Pyeloplasty is a surgical procedure used to reconstruct the renal pelvis and relieve obstructions in the ureteropelvic junction. In the procedure, the ureter is actually repositioned, and attached to an area of renal pelvic tissue that is healthy. There are a few possible incision angles, but in general, surgeons enter the body through the side of the abdomen. Depending on the specific case, sometimes a draining or kidney catheter tube is left in place for 10 to 12 days after the surgery.
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