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Bilateral hydronephrosis

Hydronephrosis - bilateral

Bilateral hydronephrosis is the enlargement of the parts of the kidney that collect urine. Bilateral means both sides.

Images

Female urinary tract
Male urinary tract

Causes

Bilateral hydronephrosis occurs when urine is unable to drain from the kidney into the bladder. Hydronephrosis is not itself a disease. It occurs as a result of a problem that prevents urine from draining out of the kidneys, ureters, and bladder.

Disorders linked with bilateral hydronephrosis include:

Symptoms

In a baby, signs of a problem are often found before birth during a pregnancy ultrasound.

A urinary tract infection in a newborn baby can signal a blockage in the kidney. An older child who gets repeat urinary tract infections should also be checked for blockage.

A higher than normal number of urinary tract infections is often the only symptom of the problem.

Common symptoms in adults may include:

Exams and Tests

The following tests can show bilateral hydronephrosis:

Treatment

Placing a tube into the bladder (Foley catheter) may open the blockage. Other treatments include:

The underlying cause of the blockage needs to be found and treated once the buildup of urine is relieved.

Outlook (Prognosis)

Surgery performed while the baby is in the womb or shortly after birth can have good results in improving kidney function.

Return of renal function can vary, depending on how long the blockage is present.

Possible Complications

Irreversible kidney damage may result from conditions that cause hydronephrosis.

When to Contact a Medical Professional

This problem is often found by the health care provider.

Prevention

An ultrasound during pregnancy can show a blockage in the baby's urinary tract. This allows the problem to be treated with early surgery.

Other causes of blockage, such as kidney stones, can be detected early if people notice warning signs of kidney problems.

It is important to pay attention to general problems with urination.

Related Information

Hydronephrosis of one kidney
Reflux nephropathy
Neurogenic bladder
Bladder outlet obstruction
Prune belly syndrome
Ultrasound pregnancy
Obstructive uropathy
Acute kidney failure

References

Elder JS. Obstruction of the urinary tract. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 540.

Frøkiaer J. Urinary tract obstruction. In: Skorecki K, Chertow GM, Marsden PA, Taal MW, Yu ASL, eds. Brenner and Rector's The Kidney. 10th ed. Philadelphia, PA: Elsevier; 2016:chap 38.

Gallagher KM, Hughes J. Urinary tract obstruction. In: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Comprehensive Clinical Nephrology. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 58.

Nakada SY, Best SL. Management of upper urinary tract obstruction. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 49.

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Review Date: 4/2/2019  

Reviewed By: Sovrin M. Shah, MD, Assistant Professor, Department of Urology, The Icahn School of Medicine at Mount Sinai, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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