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Dr. Andrew Rynne

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Suggest treatment for hydronephrosis

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Dr. Rovena Murati

General & Family Physician

Practicing since :2013

Answered : 1243 Questions

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Posted on Thu, 14 Aug 2014 in General Health
Question: I have been diagnosed with severe right hydronephrosos with interval progression of cortical thinning;
New caiiectasis left lower pole;
Left renal cyst.

Please explain in layman's language.
doctor
Answered by Dr. Rovena Murati 2 hours later
Brief Answer:
Detailed below!

Detailed Answer:
Hello!
I had gone through your query and I will try to explain these findings in the best way I can.

Your kidneys make urine by filtering wastes and extra water from your blood.This urine moves from kidneys to bladder through 2 thin tubes called ureters.
Urine flows down partly by gravity, but mainly by waves of contractions, which pass several times per minute through the muscle layers of the urethral walls.
From bladder the urine is passed out of the body through urethra.

So the urinary tract has these organs and the urine moves in this order:
-Kidneys -Ureters -Bladder - Urethra -out the body.

If there is an obstruction in urinary tract below kidney (ureter,bladder,urethra) ,the normal drainage of urine from kidneys to bladder is failed and the urine starts to build up above the level of obstruction.
If this obstruction continue the urine is build up inside the kidney causing the kidney to become swollen .This is called Hydronephrosis (kidney with water).
The renal pelvises and caliceal systems is dilated.
If the obstruction last ,the urine pressure causes compression on the kidney tissue causing a thinning of kidney cortex.
The pressure of urine above the level of obstruction will increase progressively ,and the kidney cortex will become thinner and thinner progressively.

So from the information you have provided you have severe hydronephrosis of the right kidney.This means that there is an obstruction in your right ureter or in bladder -ureter junction.
This has caused the kidney swelling,cortical thinning, the dilatation of renal calices in left lower lobe of the kidney.

There is a large number of causes for this unilateral obstruction of urine flow.

In the left kidney ,you have a cyst which is an abnormal, fluid-filled sac that is formed in your kidney.
Since it is only one cyst (not multiple cysts) it is called simple cyst.
Simple kidney cysts are often detected during an imaging test being done for another condition. Simple kidney cysts typically don't cause signs or symptoms and don't require treatment.

Hope it was of help.
Let me know if you have additional questions or doubt to clarify.I will be happy to assist you further.

Regards!
Dr.Rovena Murati
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Rovena Murati 11 hours later
What treatments are recommended for the aforesaid conditions? Can it be treated with medications?
doctor
Answered by Dr. Rovena Murati 3 hours later
Brief Answer:
It depends on the cause of hydronephrosis.

Detailed Answer:
Hello again!
Hope you are doing well.

The specific treatment will depend on the cause or urinary obstruction.
Among the common causes are:
- urethral stricture secondary to infection or injury
- benign prostatic hyperplasia or cancer of the prostate
- vesical tumor involving the bladder neck or one or both ureteral orifices
- local extension of cancer of the prostate into the base of the bladder,
occluding the ureters
- compression of the ureters at the pelvic brim by metastatic nodes from cancer of the prostate
- ureteral stone;
- retroperitoneal fibrosis or malignant tumor.

You may need to do investigations to identify the cause of hidronephrosis and then treat it.
In your case of severe right hydronephrosis with cortical thinning ,the damage of the right kidney is irreversible.
If you don't have symptoms of right hydronephrosis ,and the left kidney function is normal , your doctor may decide to monitor the condition without treatment.

Despite the cause of urinary obstruction ,there is no medication to treat this condition.
The options of treatment are surgical only and they include :

-A ureteral stent (tube that allows the ureter to drain into the bladder)
-A nephrostomy tube (allows the blocked urine to drain out of the body into a drainage bag)
-Antibiotics to reduce the risk of urinary tract infections.

As for the cyst in your left kidney ,treatment is not needed for simple kidney cysts that do not cause any symptoms. It may be monitored with periodic ultrasounds.
Simple kidney cysts that are causing symptoms or blocking the flow of blood or urine through the kidney may need to be treated using a procedure called sclerotherapy. In sclerotherapy, the doctor punctures the cyst using a long needle inserted through the skin.

Hope it was of help.
If you have further questions please feel free to ask.
Regards!

Dr.Rovena Murati
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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