Hydronephrosis - Intro

5,433 views

Published on

Published in: Education, Health & Medicine
0 Comments
19 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
5,433
On SlideShare
0
From Embeds
0
Number of Embeds
15
Actions
Shares
0
Downloads
284
Comments
0
Likes
19
Embeds 0
No embeds

No notes for slide
  • Def. from Campbell- walsh urologyAbsence of obstruction – when renal pelvis is congenitally capacious vesico-ureteral reflex
  • Bilateral fetal hydronephrosis
  • Intermittent HN: obstruction occurs, swelling and pain appear in the loin. After sometime patient passes large amount of urine following which swelling and pain disappear – Dietl’s crisisPersistent HN: It is due to persistent partial obstruction.
  • Hydronephrosis - Intro

    1. 1. Hydronephrosis Amarendra B. Singh 090201263
    2. 2. Definition • Hydronephrosis is the aseptic dilatation of the renal pelvis or calyces. • It may be associated with obstruction but may be present in the absence of obstruction. • There is accompanied destruction of kidney parenchyma. 8/18/2013 Hydronephrosis - Intro 2
    3. 3. 8/18/2013 Hydronephrosis - Intro 3
    4. 4. Etiology • It can be Unilateral or bilateral. • Unilateral maybe extramural, intramural or Intraluminal • Bilateral causes are either congenital or acquired 8/18/2013 Hydronephrosis - Intro 4
    5. 5. Unilateral hydronephrosis • By some form of ureteric obstruction, with the ureter above the obstruction being dilated. Causes A. Extramural obstruction B. Intramural (in the walls) C. Intraluminal 8/18/2013 Hydronephrosis - Intro 5
    6. 6. Causes of Unilateral hydronephrosis A. Extramural 1. Obstruction by Aberrant renal vessels (vein or artery). It is common on left side. 2. Compression by growth ( CA cervix, carcinoma rectum) 3. Retroperitoneal fibrosis (Ormond disease) 4. Retrocaval ureter 8/18/2013 Hydronephrosis - Intro 6
    7. 7. B. Intramural 1. Congenital PUJ obstruction 2. Ureterocele 3. Neoplasm of ureter 4. Narrow ureteric orifice 5. Stricture ureter following removal of stone, pelvic surgeries or tuberculosis of ureter. 8/18/2013 Hydronephrosis - Intro 7
    8. 8. C. Intraluminal 1. Stone in the renal pelvis 2. Sloughed papilla in papillary necrosis 8/18/2013 Hydronephrosis - Intro 8
    9. 9. Bilateral Hydronephrosis • Result of urethral obstruction ; but may also be caused by one of the lesions described above occurring on both sides 8/18/2013 Hydronephrosis - Intro 9
    10. 10. Causes of Bilateral hydronephrosis A. Congenital • Congenital stricture of external urethral meatus, pin-hole meatus. • Congenital posterior urethral valve. B. Acquired • BPH • Carcinoma prostate • Postoperative bladder neck scarring • Inflammatory / traumatic urethral stricture • Phimosis • Carcinoma cervix • Bladder carcinoma 8/18/2013 Hydronephrosis - Intro 10
    11. 11. Classification • Classification I —Unilateral HN —Bilateral HN without renal failure —Bilateral HN with renal failure • Classification II – Intermittent HN – Persistent HN • Classification III – HN only – HN with hydroureter • Classification IV – Extrarenal pelvic HN (80%) – Intrarenal pelvic HN (20%)8/18/2013 Hydronephrosis - Intro 11

    ×