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Hydronephrosis.pptx
- 2. Definition It is a aseptic dilatation of pelvicalcyeal system due to partial or intermittent obstruction to the outflow of urine. M:F= 2:1 Right kidney is more commonly affected
- 3. Aetiology UNILATERAL a) Extramural :Retroperitoneal fibrosis, aberrant renal vessels,tumour b) Intramural : Strictures,renal pelvis tumour, ureterocoele, c) Intraluminal : Stone , sloughed papillae BILATERAL a) Congenital : Posterior urethral valve , phimosis b) Acquired : BPH,urethral stricture , phimosis, carcinoma of prostate
- 4. Grading
- 5. Pathophysiology Due to eitological factors Obstruction of the urine flow Fluid backs up into the kidney Causing dilatation of renal pelvis Results in pressure trauma Higher pressure causes irreversible destruction of nephron Hypertrophy of the kidney as a consequence of increased work load Hydronephrosis Renal failure
- 6. Clinical Features Unilateral cases Dull aching loin pain Mass in the loin Dullness in renal angle Dietl’s crisis : pain and swelling disappears when patient passes large amount of urine Bilateral cases Loin pain Frequency Hesitancy Poor stream Mass in loin Oliguria Edema
- 7. Investigations USG (IOC) : dilated pelvic calyces system , thinning of cortex , soap bubble appearance Intravenous urogram : normal calycx is cup shaped, it gets flattened and later club shaped which eventually becomes broadened CT scan Blood urea and creatinine Urine for microscopy Whitaker test
- 8. Treatment Treat the cause Anderson hyne’s operation Davis T- tube ureterostomy Foley’s Y V Plasty Laparoscopic pyeloplasty
- 9. Complications Pyonephrosis Perinepric abscess Renal failure in bilateral cases
- 10. Thank you