2. When urine outflow is obstructed, a large fluctuating collection
or mass of urine forms in the kidney. This mass subsides as
retained urine finally passes into the ureters and bladder.
Stagnation of urine in the kidney leads to infection.
Hydronephrosis is distension of the kidney with urine that leads
to progressive atrophy and eventual destruction of the kidney.
The kidney ends up looking like a thin walled shell filled with
fluid.
3. CAUSES
Structural abnormalities cause backward pressure on the kidney when
urine flow is obstructed. Such as
Birth defects
BPH
Scarring of ureters
Cancer
Rectal impaction
Pregnancy
Kidney or ureter stone obstructs the ureters causing urine to back flow into
the kidney
4. PATHOPHYSIOLOGY
Ureter calculi or BPH
Obstruction of urinary flow
Urinary retention
Collection of urine in kidney
Severe pain in retroperitoneal region
Chronic retention leads palpable mass in kidney
5. CLINICAL MANIFESTATION
Acute: Extreme flank pain on affect side; pain may radiate to groin
Chronic: Mild discomfort over affected side due to blockage of the
urethra or ureters
Urinary tract infection
Nausea, vomiting, abdominal pain
Palpable mass over flank area seen only in extreme cases; due to
enlargement of obstructed area related to the collection of urine
7. DIAGNOSTIC EVALUATION
Physical examination : distended kidney is palpable
Bladder catheterization : detects site of the obstruction
Urinalysis : increased white blood cells and presence of
red bloodcells
Ultrasound : detects cause of obstruction
Intravenous urography : detects flow of urine through the
kidneys
8. MEDICAL MANAGEMENT
Immediate drainage of urine via needle directly into
the kidney through the skin
Hormone therapy for prostate cancer
Antibiotic to treat infection
