文档介绍：Hydronephrosis
Dept. Of Urology. shanghai Renji hospital
WANG YIXIN
Etology of hydronephrosis
hydroneprosis
intrinsic strinsic strictrue
high insertion of the ureter
PUJ
nephroptosis
presion
renal pelvis stone or tumor
Etology of hydronephrosis
hydronephrosis
visicoureteral reflux
obstruction distal to the ureteropelvic junction:
stone, tumor, extrinsic pression,
myoneurogenic disease, ureterocele, CAB, ca of pelvic viscera
bladder outer obstruction: CAP, BPH
urethral obstruction
pregnancy
Pathology of hydronephrosis
shows evidence of hyperactivity and hypertrophy than dilatation and atony
loss of peristaltic activity
of the renal parenchyma
pression of the arcuate vessels ischmic atrophy
The result of renal pelvis-obstruction
Symptoms and signs of hydronephrosis
(in some cases)
is felt in the renal area
infection, dysuria frequency
vague GI symptoms
large hydronephrosis can be palpable
Diagnosis of hydronephrosis
1. symptoms and signs
2. ultrasound
3. IVU
4. Cystourethralgram
5. Cystoscopy
6. RGP
7. Delayed empty
8. Isotope renography
culture
Isotope renography
Treatment of hydronephrosis
1. . Antibiotic therapy
2. Prompt drainage
3 corrected to the cause
4. Relief of lower tract obstruction
catheter drainage ,urinary diversion , indwelling pigtail ureteral catheter
5. Nephrectomy( tumor or nonfunction kidney)
Correction of pelvi-ureteric stenosis