What is Hydronephrosis in Children?

Hydronephrosis is the swelling of one or both kidneys. Swelling of the kidney happens when urine cannot drain out of a kidney and is trapped there. It might be caused by ureter tube blockage in place, or by an anatomical flaw that prevents urine from properly draining.

Hydronephrosis can occur at any age. Hydronephrosis in children can be diagnosed during infancy or sometimes during a prenatal ultrasound before the baby is born.

What are the symptoms of hydronephrosis in children?

The signs and symptoms of hydronephrosis depend on the underlying cause. In most cases, there are no symptoms. Antenatal hydronephrosis in a baby does not typically produce symptoms after birth.

In the case of symptoms appearing, they may include:

Intense pain in your sides, abdomen or back.
Vomiting or nausea
Painful urination.
You have blood in your urine.
You have a urinary tract infection (UTI).
You can't empty your bladder completely.
You pee more or less than usual.

The risk of UTI is higher for any person with hydronephrosis because pee is retained within the body. This leads to bacterial growth within the urinary tract. The signs of UTI are the following:

Fever, chills, and fatigue.
Pain or burning sensation during urination.
Cloudy urine that is not clear.

What causes hydronephrosis in children?

Normally, urine flows down from the kidney through a tube called a ureter which drops into the bladder and subsequently out of the body. However, at some point, it may back up or stay inside the kidney or in the ureter. That is when hydronephrosis develops.

Hydronephrosis usually occurs due to these common causes:

Partial urinary tract obstruction: Urinary tract obstruction often occurs where the kidney meets the ureter. In some instances, blockage can occur where the ureter joins the bladder.
Vesicoureteral reflux: Vesicoureteral reflux is a condition in which urine flows back through the ureter from the bladder up into the kidney. Normally, urine flows only one way down the ureter. The backward flow of urine prevents the kidney from emptying properly and leads to enlargement of the kidney.

Other, less common causes of hydronephrosis are kidney stones, a tumor in the abdomen or pelvis, and problems in nerves that lead to the bladder.

How is hydronephrosis diagnosed?

Your physician will likely refer you to a doctor who specializes in treating conditions that affect the urinary system, called an urologist, for your diagnosis.

Tests for Diagnosing Hydronephrosis May Include:

A blood test to check on kidney function
A urine test to check for symptoms of infection or urinary stones that could cause a blockage
An ultrasound imaging exam, where your doctor can view the kidneys, bladder and other urinary structures for possible problems
A special X-ray of the urinary tract through a special dye outlining the kidneys, ureters, bladder and urethra, and taking pictures before and during urination.

If a diagnosis is confirmed, your doctor may prescribe additional imaging exams such as a CT scan or MRI. Another possibility could be a test known as a MAG3 scan that analyzes the function and drainage in the kidney.

What are the treatment options for hydronephrosis in children?

The usual treatment of hydronephrosis is removing any blockage to the flow of urine. The treatment that your doctor makes for you depends on the causes of your obstruction.

If a blocked ureter is the cause of your condition, your doctor may need to do one of the following:

Insert a ureteral stent, which is a tube that lets the ureter drain into the bladder
Insert a nephrostomy tube, through which the urine will be drained backward
Administer antibiotics to contain infection

Your doctor might have to take out the obstruction surgically. If the obstruction is in the form of scar tissue or a blood clot, your doctor will remove the affected area. They can reconnect the healthy endings of your ureter so that normal urine flow resumes.

If your hydronephrosis is caused by a kidney stone, you might need surgery to have it removed. Your doctor may then choose to do an endoscopic surgery-in which tiny instruments are used to perform the surgery-which would reduce your healing and recovery time quite considerably.

Your doctor might give you antibiotics. This will prevent you from getting a kidney infection.

What are the complications of hydronephrosis?

In extreme hydronephrosis, your kidneys can be damaged, leading to kidney failure. In such cases, treatment with dialysis or a kidney transplant may be required. Most people who develop hydronephrosis recover without significant damage to their kidneys.

What are ways of preventing hydronephrosis?

Since hydronephrosis is an underlying condition, prevention is essentially based on the avoidance or timely treatment of that underlying cause. Knowing the risk factors for hydronephrosis helps prevent it.

The conditions that can predispose you to hydronephrosis include the following:

Kidney stones.
A history of cancer in your urinary tract.
Urinary tract surgeries previously performed.
Urinary tract infections in the past, including UTIs.
Blood clots.
An enlarged prostate.
Being pregnant, because your uterus can compress your pelvis.

What is the long-term outlook?

Treatment depends upon how early it is detected. Relief of the obstruction is crucial for your kidney to return to normal function. When surgery is required due to hydronephrosis, the chance of a full recovery is approximated to be at 95 percent.

When should I call my healthcare provider?

Call your provider if you experience any of the following:

Severe or sudden pain in your side or back.
Vomiting.
Changes in urination patterns, having urinated more or less than normal. Painful, burning urination or blood present in the urine.
A fever exceeding 100.5 degrees Fahrenheit (38 degrees Celsius).

Why Choose Tender Palm Super Speciality Hospital for Hydronephrosis treatment in Children in Lucknow, India?

Tender Palm Super-Speciality Hospital has the most trusted team of Pediatric Urologists with advanced diagnostic equipment and child-friendly care for pediatric Hydronephrosis treatment in Lucknow, India. Our Pediatric Urology department follows international safety standards and has years of experience in successfully managing children's Urological diseases.