A mother was very distressed. Her baby, just 30 days after giving birth, found hydronephrosis in the right kidney after performing coloring over time. Although the doctor told her that the hydronephrosis of the child is not heavy, it can be observed and reviewed. But the mother was still worried about the child's condition and asked me again and again: Is it really possible to do without surgery? What is hydronephrosis?
1. First, let’s take a look at what is hydronephrosis
The kidney is an important metabolic organ in our body. Through the kidney’s filtration, the body’s metabolic waste is removed. Excreted with urine.
When there are some reasons that cause the urine produced in the kidney to be discharged slowly and not smoothly, the urine will stagnate in the renal pelvis and renal calyx, causing the renal pelvis and renal calyx to expand to store more urine. It is called hydronephrosis.
is like blowing a balloon. The more gas in the balloon, the bigger the balloon is blown, and the higher the pressure on the balloon wall.
The same is true for hydronephrosis. The heavier the hydronephrosis, the higher the pressure in the kidney, and the greater the damage to the kidney.
Therefore, for moderate to severe hydronephrosis, we should still actively treat it to reduce the pressure in the kidney and prevent excessive kidney damage. With mild hydronephrosis, the pressure in the kidney is not increased, and the kidney damage is small, so you can continue to observe.
2. Causes of hydronephrosis
Common causes of unilateral hydronephrosis are temporary or physiological, congenital ureteral stenosis. Adults also have kidney and ureteral stones, ureteral tumors, etc. Urinary tract obstruction.
The common cause of bilateral hydronephrosis is lower urinary tract obstruction caused by posterior urethral valves, prostatic hyperplasia, neurogenic bladder, etc.
To make another analogy, our kidneys are equivalent to two toilets with double bathrooms. When a sewer (ureter) connecting the toilet is blocked, the water in our toilet will not go down. When our main sewer (urethra) is blocked, both toilets will have poor drainage.
Hydronephrosis causes more damage to the body.
3. Symptoms of hydronephrosis
Symptoms of hydronephrosis are not typical, mainly manifested as pain and discomfort in the waist and abdomen on the side of the hydronephrosis, and a few are accompanied by hematuria. Abdominal masses can be palpable in those with obvious water accumulation. When accompanied by infection, chills, fever, and lower back pain may increase.
There are also some patients with hydronephrosis who have no obvious symptoms, and most of them occur in patients with long-term and slow progressing hydronephrosis. Some hydronephrosis has progressed to severe hydronephrosis, and the patient can still feel nothing when the kidneys basically have no function.
Fourth, hydronephrosis severity classification
According to different ages, there are different standards for the classification of hydronephrosis. Generally speaking, only the renal pelvis is dilated without mild hydronephrosis, and the renal calyx is also expanded to a moderate degree. The renal pelvis and renal calyx are fused, and the kidney is ultra-thin, which is severe hydronephrosis.
American Fetal Urology Association and Pediatric Nephrology Association and other organizations classified the hydronephrosis after birth into UTD PI (low risk), UTD P2 (medium risk), UTD P3 (high risk) groups. See the table below.
5. Whether surgery is needed
Surgery is not recommended for neonatal hydronephrosis within 1 month, and should be reviewed and followed up.
If hydronephrosis worsens during the follow-up process, the anterior and posterior diameter of the renal pelvis has increased by 10mm or more, and the hydronephrosis is severe, the re-examination in 2 to 4 weeks still worsens, surgery may be considered.
As a result of research found that after the first B-ultrasound examination after birth, 91.9% of children with mild, 76.3%, and 22.2% with severe congenital hydronephrosis returned to normal before 1 year old.
After listening to my introduction, the mother felt much more relaxed.
