Hydronephrosis

Diagnosis

Diagnosis of hydronephrosis involves several steps that help identify the cause of kidney swelling and any related urinary issues. Your healthcare professional begins by discussing your symptoms and performing a physical examination. You may be referred to a urologist, a specialist who diagnoses and treats urinary system conditions.

Tests commonly used to detect hydronephrosis include:

• Blood tests to evaluate kidney function.

• Urine tests to check for infection or kidney stones that may be blocking urine flow.

• Ultrasound imaging to visualize the kidneys, bladder, and urinary tract for signs of swelling or blockage.

• CT urogram, an X-ray exam using special dye to outline the kidneys, ureters, bladder, and urethra. It helps capture detailed images before and after urination.

• MRI scans or a MAG3 scan may also be suggested to assess kidney function and urine drainage more precisely.

During pregnancy, routine ultrasound exams can sometimes detect hydronephrosis in unborn babies, allowing for early monitoring.

Treatment

Treatment for hydronephrosis depends on its cause and the severity of symptoms. The main goal is to relieve swelling in the kidneys, restore normal urine flow, and prevent long-term damage. Some mild cases resolve naturally without intervention.

Medications

Your healthcare provider may prescribe:

• Pain-relieving medicines to manage discomfort.

• Antibiotics to treat or prevent urinary tract infections, especially in babies with mild hydronephrosis.

In many infants, hydronephrosis improves on its own over time. Regular imaging tests help monitor kidney health and confirm recovery without surgery.

Surgery or other procedures

Surgery may be necessary if hydronephrosis results from a blockage or backward urine flow that doesn’t improve with other treatments. It can also be used to relieve severe pain or vomiting.

Common causes treated surgically include:

• Kidney stones

• Enlarged prostate

• Blocked or narrowed ureter

• Cancer affecting the urinary tract

In some cases, a thin tube called a catheter is inserted into the bladder to help drain excess urine and relieve pressure on the kidneys.

Prompt diagnosis and treatment greatly improve outcomes and help prevent lasting kidney damage.

Preparing for your appointment

You may begin by consulting your primary healthcare provider, who may refer you to a urologist. Preparing well for your appointment can help ensure you get the most accurate diagnosis and treatment plan.

What you can do before your appointment:

• Ask about any preparations needed before testing, such as fasting.

• Make a list of your symptoms, even those that seem unrelated.

• Note key personal details, including stress factors or family medical history.

• Bring a list of all medications, vitamins, and supplements you take.

• Write down any questions you want to ask your healthcare provider.

If possible, bring a family member or friend to help remember the information discussed during the visit.

Helpful questions to ask include:

• What’s the likely cause of my symptoms?

• What tests do I need?

• Is my condition temporary or long-term?

• What treatment options are available for me?

• Are there any restrictions I should follow?

• Should I see a specialist?

• Are there educational resources or websites you recommend?

What to expect from your doctor

Your healthcare professional will likely ask questions such as:

• When did your symptoms begin?

• Are your symptoms constant or occasional?

• How severe are your symptoms?

• What seems to improve or worsen your symptoms?

These answers help guide the diagnostic process and determine the best course of treatment for your specific situation.