Hydronephrosis - Cause

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What causes hydronephrosis?

There are numerous causes of hydronephrosis that are categorized based upon the location of the swelling and whether the cause is intrinsic (located within the urinary collecting system), extrinsic (outside of the collecting system) or if it due to an alteration in function.

Examples of intrinsic causes of hydronephrosis

Ureter

  • Kidney stone. Likely the most common reason to have unilateral hydronephrosis is a kidney stone that causes obstruction of the ureter. The stone gradually moves from the kidney into the bladder but if it should act like a dam while in the ureter, urine will back up and cause the kidney to swell. This would be classified as an intrinsic obstruction.
  • Blood clot
  • Stricture or scarring

Bladder

  • Bladder cancer
  • Bladder stones
  • Cystocele
  • Bladder neck contracture

Urethra

  • The inability to empty the bladder (urinary retention) for any reason may cause bilateral hydronephrosis.
  • Urethral stricture
  • Urethral valves

Examples of extrinsic causes of hydronephrosis

Ureter

  • Tumors or cancers that compress the ureter and prevent urine flow. Examples include lymphoma and sarcoma, especially if they are located in the retroperitoneum, where the kidneys and ureters are located behind the sac that contains the bowel.
  • Retroperitoneal fibrosis
  • Ovarian vein syndrome
  • Cancer of the cervix
  • Cancer of the prostate
  • Pregnancy
  • Uterine prolapse
  • Scarring due to radiation therapy

Urethra

  • Prostate hypertrophy or swelling is a common cause of urinary retention and subsequent hydronephrosis in males.
  • Prostate cancer

Examples of functional causes of hydronephrosis

Bladder

  • Neurogenic bladder or the inability of the bladder to function properly occurs because of damage to the nerves that supply it. This may occur in brain tumors, spinal cord injuries or tumors, multiple sclerosis, and diabetes among other causes.
  • Vesicoureteral reflux where urine flows backwards from the bladder into the ureter. Prenatal hydronephrosis is an example, though it may occur at any time in life.
Return to Hydronephrosis

See what others are saying

Comment from: Sharon B, 65-74 Female (Patient) Published: April 19

My hydroureteronephrosis was caused when I had a large ovarian cyst removed. Unfortunately the blockage was at the site where the ureter connects to the bladder and not caught in time and I lost function of my left kidney.

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Comment from: Shah, 25-34 Female (Patient) Published: May 02

I was diagnosed with ureteropelvic junction (UPJ) obstruction 2 days after having a severe flank pain. I went under robotic pyeloplasty surgery where they remove the scarring tissues and repair the area. I had severe stent pain because my physician did not use the soft silicone based stent for me. I suffered with hydronephrosis 1.5 year because of my surgeon. He removed my stent 7th day after my surgery without replacing it with another. I had recurrent obstruction and my kidney burst and I had bad urine retention all over my back.

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