The term hydronephrosis stems from Greek meaning “water kidney condition.” Hydronephrosis is the result of inadequate drainage of urine relative to the amount of urine produced by the kidney. Causes of hydronephrosis can be classified into functional and obstructive etiologies with leading causes in adults including pregnancy, urolithiasis, stricture, urothelial carcinoma, urinary tract infection, and neurogenic bladder. Symptoms associated with hydronephrosis are usually due to the underlying cause but are often associated with flank pain. Untreated hydronephrosis can lead to kidney injury and chronic kidney disease. Conventional medical and surgical therapies are tailored for the patient’s renal function and underlying etiology. With the advent and continued improvement of image guidance, percutaneous access is an important diagnostic and treatment approach allowing for antegrade pyelography and percutaneous nephrostomy. Percutaneous nephrostomy has become a key treatment for hydronephrosis as a minimally invasive urinary diverting procedure which limits hydronephrosis associated renal injury, allows for the clearance of infected urine, and can offer additional time for medical optimization of patients prior to more invasive therapies. An understanding of the principal concepts in pre-procedural planning, procedural steps, and postprocedural care is critical to delivering safe and effective care to a patient with hydronephrosis.
KeywordsHydronephrosis Hydroureter Nephrostomy Percutaneous Interventional Radiology Nephrolithiasis Kidney Stone Obstructive
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