This document provides tips for using a PowerPoint presentation on hydronephrosis: 1. The slides can be freely downloaded, edited, and modified. Blank slides are included to engage students by asking what they know about each topic before showing the content slide. 2. This active learning approach involves showing the blank slides, soliciting student input, and then presenting the content slide. This cycle repeats for each topic. 3. Users can also study on their own by viewing blank slides, thinking about the topic, and then reading the content slide. The presentation encourages an interactive approach to learning about the causes, features, diagnosis, and management of hydronephrosis. Blank slides promote student participation before

1. Tips on using my ppt.
1. You can freely download, edit, modify and put your
name etc.
2. Don’t be concerned about number of slides. Half the
slides are blanks except for the title.
3. First show the blank slides (eg. Aetiology ) > Ask
students what they already know about ethology of
today's topic. > Then show next slide which enumerates
aetiologies.
4. At the end rerun the show – show blank> ask questions >
show next slide.
5. This will be an ACTIVE LEARNING SESSION x
three revisions.
6. Good for self study also. Good for self study also.
Display blank slide> Think what you already know about
this > Read next slide.

2. Introduction

3. Introduction
• Hydronephrosis is defined as distention of
the renal calyces and pelvis with urine as a
result of obstruction of the outflow of urine
distal to the renal pelvis.
• Obstructive uropathy refers to the functional
or anatomic obstruction of urinary flow at
any level of the urinary tract. Obstructive
nephropathy is present when the obstruction
causes functional or anatomic renal damage.

4. • can be physiologic or pathologic. It may be
acute or chronic, unilateral or bilateral. It
can be secondary to obstruction of the
urinary tract, but it can also be present even
without obstruction.

5. Etiology

6. Etiology
• Congenital
• Traumatic
• Infections /Infestations
• Neoplastic (Benign/Malignant)
• Degenerative

7. Etiology
the level within the urinary tract
• intrinsic,
• extrinsic,
• functional.

8. Etiology intrinsic,
• Ureter
• Intrinsic ureter-level causes can be as
follows:
• Ureteropelvic junction stricture
• Ureterovesical junction obstruction
• Papillary necrosis
• Ureteral folds
•

9. Etiology intrinsic,
• Ureteral valves
• Ureterovesical reflux
• Ureteral stricture (iatrogenic)
• Blood clot
• Benign fibroepithelial polyps
• Ureteral tumor
• Fungus ball
• Ureteral calculus
• Neurogenic bladder
• Extrinsic ureter-level causes can be as
follows:

10. • Retroperitoneal lymphoma
• Retroperitoneal sarcoma
• Cervical cancer
• Prostate cancer
• Retroperitoneal fibrosis
• Aortic aneurysm
• Inflammatory bowel disease
• Ovarian vein syndrome
• Retrocaval ureter
• Uterine prolapse
• Pregnancy

11. • Iatrogenic ureteral ligation
• Ovarian cysts
• Diverticulitis
• Tuboovarian abscess
• Retroperitoneal hemorrhage
• Lymphocele
• Pelvic lipomatosis
• Radiation therapy
•

12. Etiology intrinsic,
• Ureterocele
• Endometriosis
• Tuberculosis
• Retrocaval ureter
• Functional ureter-level causes can be as
follows:
• Gram-negative infection
• Neurogenic bladder
•
•

13. Extrinsic ureter-level causes

14. Extrinsic ureter-level causes
• Retroperitoneal lymphoma
• Retroperitoneal sarcoma
• Cervical cancer
• Prostate cancer
• Retroperitoneal fibrosis
• Aortic aneurysm
• Inflammatory bowel disease
•
•

15. Extrinsic ureter-level causes
• Ovarian vein syndrome
• Retrocaval ureter
• Uterine prolapse
• Pregnancy
• Iatrogenic ureteral ligation
• Ovarian cysts
• Diverticulitis

16. Extrinsic ureter-level causes
• Tuboovarian abscess
• Retroperitoneal hemorrhage
• Lymphocele
• Pelvic lipomatosis
• Radiation therapy

17. Intrinsic bladder-level causes :

18. Intrinsic bladder-level causes :
• Bladder carcinoma
• Bladder calculi
• Bladder neck contracture
• Cystocele
• Primary bladder neck hypertrophy
• Bladder diverticula
• Functional bladder-level causes can be as
follows:
• lipomatosis.

19. Intrinsic bladder-level causes :
• Neurogenic bladder
• Vesicoureteral reflux

20. Intrinsic urethra-level causes

21. Intrinsic urethra-level causes
• Urethral stricture
• Urethral valves
• Urethral diverticula
• Urethral atresia
• Labial fusion
• Hypospadias and epispadias

22. Extrinsic urethra-level causes

23. Extrinsic urethra-level causes
• Benign prostatic hyperplasia
• Prostate cancer
• Urethral and Penile cancer
• Phimosis

24. Clinical Features

25. Clinical Features
• Demography
• Symptoms
• Signs
• Complications

26. Clinical Features: Symptoms

27. Clinical Features: Symptoms
Symptoms vary depending on whether the
hydronephrosis is acute or chronic.

28. Clinical Features: Symptoms
• Asymptomatic
• Pain ureteric colic flank pain no pain
• Site of pain – level of obstruction
• Anuria
• Hematuria
• Fever

29. Clinical Features: Signs

30. Clinical Features: Signs
• lower extremity edema
• Costovertebral angle tenderness .
• an abdominal mass could represent an
enlarged kidney
• palpable bladder in a male infant, especially
after voiding,

31. Diagnostic Studies

32. Diagnostic Studies
• Lab works
• Imaging

33. Laboratory Studies

34. Laboratory Studies
• Urinalysis is
– Pyuria
– Microscopic hematuria
• Complete blood cell count - leukocytosis,
• Serum chemistry studies
– elevation of BUN and creatinine levels
– hyperkalemia

35. Imaging Studies

36. Imaging Studies
• Renal ultrasonography
• a plain film of the abdomen
• computed tomography (CT) scanning
• Intravenous pyelography (IVP)
• magnetic resonance imaging (MRI)
• A voiding cystourethrography (VCUG)
VUR
• Antegrade or retrograde pyelography

37. Differential Diagnosis

38. Differential Diagnosis
• Peripelvic cyst
• Congenital megacalices
• Calyceal diverticula
• Capacious extrarenal pelvis<>
• High urine flow
• Pyelonephritis

39. Non Operative Therapy

40. Non Operative Therapy
• pain control
• treatment or prevention of infection

41. Operative Therapy

42. Operative Therapy
• Minimally invasive
• Open Surgery

43. Management

44. Management
• Endoscopic stone removal
• extracorporeal shockwave lithotripsy
• Urethral catheterization
• Ureteral stent placement in cases of intrinsic
and extrinsic causes of hydronephrosis.
• cystoscopy
• retrograde pyelography.
• percutaneous nephrostomy

45. Operative Therapy

46. Operative Therapy
• Retroperitoneal fibrosis,
• retroperitoneal tumors, and aortic
aneurysms.
• Some stones

47. Questions
• Full question
• Short Note
• Long case
• Short case
• MCQs

48. Get this ppt in mobile
1. Download Microsoft
PowerPoint from play
store.
2. Open Google assistant
3. Open Google lens.
4. Scan qr code from
next slide.

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