Dr. med. Dirk Manski

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Hydronephrosis and Upper Urinary Tract Obstruction

Definition of Hydronephrosis

Hydronephrosis is caused by an obstruction of the urine flow from the kidney. Hydronephrosis means literally "water inside the kidney" and refers to the distension and dilation of the pyelocalyceal system. For classification see section ureter ultrasonography.

Differential diagnosis of Hydronephrosis

Urinary retention:

Ureter diseases causing hydronephrosis (intrinsic causes):

Iatrogenic Causes of Hydronephrosis:

Hydronephrosis due to Vascular Diseases:

Gynecological Diseases Causing Hydronephrosis:

Hydronephrosis caused by Diseases of the Retroperitoneum:

Diagnostic Work-Up in Hydronephrosis

Classification of hydronephrosis in grade I–IV (Beetz and others, 2001).
Hydronephrosis grade I: dilatation of the renal pelvis without dilatation of the calyces. Prominent reflex of the renal sinus without signs of parenchymal atrophy.
Hydronephrosis grade II: dilatation of the renal pelvis and calyces. Attenuated sinus reflex. No signs of parenchymal atrophy.
Hydronephrosis grade III: Missing or marginal sinus reflex. Minor signs of organ atrophy present (flat papillae and blunt fornices).
Hydronephrosis grade IV: massive dilatation of the renal pelvis and calyces. Borders between renal pelvis and calyces are missing. Significant signs of renal atrophy (thin parenchyma).
figure classification and grading of hydronephrosis

Index: 1–9 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z


Gleason, P. E.; Kelalis, P. P.; Husmann, D. A. & Kramer, S. A.
Hydronephrosis in renal ectopia: incidence, etiology and significance
J Urol, 1994, 151, 1660-1

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