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
Amarendra B. Singh
• 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
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• It can be Unilateral or bilateral.
• Unilateral maybe extramural, intramural or
• Bilateral causes are either congenital or
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• By some form of ureteric
obstruction, with the ureter
above the obstruction being
A. Extramural obstruction
B. Intramural (in the walls)
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Causes of Unilateral hydronephrosis
1. Obstruction by Aberrant renal vessels (vein or
artery). It is common on left side.
2. Compression by growth ( CA cervix, carcinoma
3. Retroperitoneal fibrosis (Ormond disease)
4. Retrocaval ureter
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1. Congenital PUJ obstruction
3. Neoplasm of ureter
4. Narrow ureteric orifice
5. Stricture ureter following removal of stone, pelvic
surgeries or tuberculosis of ureter.
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1. Stone in the renal pelvis
2. Sloughed papilla in papillary necrosis
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• Result of urethral obstruction ; but may also
be caused by one of the lesions described
above occurring on both sides
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