Learn About Bilateral Hydronephrosis

What is the definition of Bilateral Hydronephrosis?

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

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What are the alternative names for Bilateral Hydronephrosis?

Hydronephrosis - bilateral

What are the causes of Bilateral Hydronephrosis?

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:

  • Acute bilateral obstructive uropathy - sudden blockage of the kidneys
  • Bladder outlet obstruction - blockage of the bladder, which does not allow drainage
  • Chronic bilateral obstructive uropathy - a gradual blockage of both kidneys is most often from a common singular obstruction
  • Neurogenic bladder - poorly functional bladder
  • Posterior urethral valves - flaps on the urethra that causes poor emptying of the bladder (in boys)
  • Prune belly syndrome - poorly emptying bladder that causes distention of the belly
  • Retroperitoneal fibrosis - increased scar tissue that blocks the ureters
  • Ureteropelvic junction obstruction - blockage of the kidney at the point where the ureter enters the kidney
  • Vesicoureteric reflux - backup of the urine from the bladder up to the kidney
  • Uterine prolapse - when the bladder drops down and presses into the vaginal area. This causes a kink in the urethra, which prevents the urine from emptying out of the bladder.
What are the symptoms of Bilateral Hydronephrosis?

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:

  • Back pain
  • Nausea, vomiting
  • Fever
  • Need to urinate often
  • Decreased urine output
  • Blood in the urine
  • Urinary incontinence
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What are the current treatments for Bilateral Hydronephrosis?

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

  • Draining the bladder
  • Relieving pressure by placing tubes in the kidney through the skin
  • Placing a tube (stent) through the ureter to allow urine to flow from the kidney to bladder

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

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What is the outlook (prognosis) for Bilateral Hydronephrosis?

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.

What are the possible complications of Bilateral Hydronephrosis?

Irreversible kidney damage may result from conditions that cause hydronephrosis.

When should I contact a medical professional for Bilateral Hydronephrosis?

This problem is often found by the health care provider.

How do I prevent Bilateral Hydronephrosis?

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.

Female urinary tract
Male urinary tract
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What are the Latest Advances for Bilateral Hydronephrosis?
Palliative radiation treatment used for multiple purposes in a single irradiation field.
Summary: Palliative radiation treatment used for multiple purposes in a single irradiation field.
Severe urinary tract damage secondary to primary bladder neck obstruction in women.
Summary: Severe urinary tract damage secondary to primary bladder neck obstruction in women.
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A Case of Bilateral Ureteral Stenosis Treated by Upper Urinary Tract Reconstruction Using an Ileal Ureter.
Summary: A Case of Bilateral Ureteral Stenosis Treated by Upper Urinary Tract Reconstruction Using an Ileal Ureter.
Who are the sources who wrote this article ?

Published Date: April 18, 2021
Published By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Elder JS. Obstruction of the urinary tract. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 555.

Frøkiaer J. Urinary tract obstruction. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 37.

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: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 89.