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Had UTI, urine test showed pus cells, hydrouretonephrosis. Thickening and trabeculation in UB walls

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Orthopaedic Surgeon
Practicing since : 2011
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i had uti and urine routine test showed pus cell fulfilled in urine ,Albumin (+) RBC 1-2 /HPF ,KUB ultrasound report said UTI with bilateral mild to moderate hydroureteronephrosis and after medication i had urine routine test.the report says pus cells are 3to 6HPF and trace of albumin.
MY KFT is normal,iVP says normal excretion and function of both kidneys.Note made of moderate diffuse thickening and trabeculation in ub walls with significant post void residue suggestive of bladder outflow obstruction.
Posted Mon, 21 May 2012 in Urinary and Bladder Problems
Answered by Dr. Aashish Raghu 1 hour later

Thanks for the query.

Do you have any burning sensation on passing urine or any lower abdominal or back pain ?

Do you pass normal amount of urine daily ?

Do you have any swelling or edema of the feet or any other part of the body ?

According to your history and the clinical reports provided, it appears to be a chronic hydronephrosis. It is generally benign and not much to worry about.

The fact that you have significant bladder outflow obstruction suggests the possible reason for your UTI's. Since the urine gets collected in the bladder, it tends to get infected and regurgitate upwards into the kidneys and cause hydronephrosis. This needs to be thoroughly investigated by your Urologist as your kidneys may start getting damaged if this problem is not solved. Your urinary bladder sphincter and surrounding muscles need to get less tight or infection will keep happening due to urinary retention.

The Pus cells and few red blood cells signify an ongoing infection but appears under control since KFT's are normal. The other imaging findings suggest chronic infection.

There is no emergency as of now. Everything seems to be under control. Do continue drinking 2-3 litres of water daily, follow your Doctor's orders on medication, food habits as well. Avoid much salt in diet.

Do get investigated for possibility of diabetes, hypertension, connective tissue disorders as in early stages they may not be discernable and can cause complications later if present.

I hope I have answered your query. I will be available to answer your follow up queries.


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Follow-up: Had UTI, urine test showed pus cells, hydrouretonephrosis. Thickening and trabeculation in UB walls 36 hours later
I visited my physician and now he has advised for uroflometry and cystoscopy he has continued Niftas(nephtontoin sustained release tablets) although the pus cell has reduced from fulfilled HPF to 4 to 6 HPF and my urine flow has also improved a lot.can it be cured by medication only.i dont want to go for cystoscopy. please suggest.
Answered by Dr. Aashish Raghu 9 minutes later

Thanks for your reply.

Cystoscopy is a method where an endoscope with a camera will be inserted inside your urethra and is able to visualise the inside of your urinary bladder and also if there is any block of the urinary sphincter causing obstruction. It can take automatic biopsies as well so that you will have a sure diagnosis of possible chronic bladder infection like Cystitis. It is a relatively painless procedure because anesthetic will be used.

Uroflometry will be done in such a way a graph is plotted to see what kind of obstruction is there for the urine flow. You will just have to urinate into a bowl and the graph is plotted.

It is good to know the pus cells in your urine has drastically reduced. This means the infection is in process of getting under control. Do continue taking Niftas antibiotic which will help eradicate the infection. Drink 2-3 litres of water daily.

You may discuss about the need for Cystoscopy with your Urologist because your Doctor would like to find anything wrong with your urinary bladder like a mass, muscle thickening, chronic infection or tumor inside which may be causing the obstruction to urine flow as well. This is the best method to check. Besides since you will be under anesthesia, you will not feel much uncomfortable when the procedure is done.

I hope I have answered your query.

Wishing speedy recovery.


Above answer was peer-reviewed by
Follow-up: Had UTI, urine test showed pus cells, hydrouretonephrosis. Thickening and trabeculation in UB walls 5 hours later
Thanks for your answer doctor,but i did not have chronic uti this is the first time i want to avoid cystoscopy just because i dont want to bear post test complications if in case any medicine is the best way and its not so severe and showing improvemnet even though i had stopped medication a week back and then i went for urine test. one more point which needs to be noted is my culture doesnot show any kind of growth even when i was not taking any antibiotics. i may go for the cystoscopy ones the pus cell count come to nil and again if it appears some time later.Please suggest.
Answered by Dr. Aashish Raghu 2 hours later

You may choose to do the Cystoscopy as and when you feel better. Do discuss this with your Urologist about your discomfort of getting this invasive investigation done when you are still having infection.

Continue taking antibiotics, drinking plenty of water. Get your urine test results checked after a month to look for response to treatment.

I hope I have answered your query.

Wishing speedy recovery.


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