Hydronephrosis – Pyeloplasty

Hydronephrosis is a condition that occurs when the kidney expands due to the accumulation of urine that cannot drain normally. This typically arises from an obstruction preventing urine from freely flowing through the urinary tract, which can be caused by various factors such as kidney stones, anomalies in the structure of the urinary tract, or tumors putting pressure on the ureter. As urine accumulates, the kidneys expand and may experience increased pressure, leading to pain and other symptoms, and in the long term, it can damage kidney tissue. It is important to recognize and treat hydronephrosis promptly to avoid serious complications.

Diagnosing hydronephrosis usually begins with a discussion and physical examination, followed by a series of tests. Ultrasound is often the first step, as it can quickly and non-invasively show whether there is kidney enlargement. Other tests may include a CT scan, which provides a more detailed view of kidney anatomy, or an intravenous urogram (IVU), which uses contrast dye to better visualize the urinary tract. In some cases, diagnostic cystoscopy may be necessary, where a thin tube with a camera is inserted through the urethra to closely examine the inside of the urinary bladder and ureter openings.

Treatment of hydronephrosis focuses on removing the underlying cause preventing normal urine flow. In the case of a narrowing (stenosis) in the ureter, one of the effective treatment methods is Pyeloplasty. This surgical procedure involves reconstructing the ureter to improve the flow of urine from the kidney to the urinary bladder. During pyeloplasty, the surgeon removes the narrowed portion of the ureter and reconnects the healthy ends, allowing urine to flow freely again. In some cases, a stent may be used to ensure that the ureter remains open during the healing process. This is a highly specialized procedure that requires an experienced urologist but can significantly improve the quality of life for patients with hydronephrosis.