What Department Should You Visit for Hydronephrosis?

When experiencing hydronephrosis—a condition where the kidneys become swollen due to a buildup of urine—it's essential to seek medical attention promptly. The recommended department for diagnosis and treatment is urology. This is because hydronephrosis is most commonly caused by obstructions within the urinary tract, which fall under the specialty of urological care.

Understanding the Causes of Kidney Swelling

Hydronephrosis typically occurs when urine cannot drain properly from the kidney to the bladder, leading to increased pressure and swelling in the renal system. Urologists are specially trained to diagnose and manage these blockages, making them the ideal healthcare providers for such cases.

Types of Hydronephrosis: Unilateral vs. Bilateral

There are two primary forms of hydronephrosis, each with distinct underlying causes:

1. Unilateral Hydronephrosis (One-Sided Kidney Involvement)

In this form, only one kidney is affected, usually due to an obstruction in the ureter—the tube that carries urine from the kidney to the bladder. Common causes include:

• Ureteral stones: Hard deposits that form in the kidney and can block the ureter.
• Inflammatory strictures: Narrowing of the ureter caused by chronic inflammation or scarring.
• Ureteral tumors: Abnormal growths that may compress or block the passage of urine.
• External compression: Pressure from surrounding tissues or masses, such as enlarged lymph nodes or pelvic organs, can also impair urine flow.

2. Bilateral Hydronephrosis (Both Kidneys Affected)

This more serious condition involves both kidneys and often indicates a blockage below the level of the ureters, typically in the bladder or urethra. Potential causes vary between men and women:

In male patients, the most frequent cause is benign prostatic hyperplasia (BPH). As the prostate gland enlarges with age, it can squeeze the urethra, preventing the bladder from emptying completely. Over time, this backpressure affects both kidneys, leading to bilateral hydronephrosis.

For female patients, a common issue is bladder neck obstruction, which functions similarly to BPH in men. Additionally, both genders can develop urethral strictures—narrowing of the urethra due to injury, infection, or inflammation. When the urethra is constricted, urine remains trapped in the bladder, increasing pressure throughout the urinary system and eventually affecting both kidneys.

Why See a Urologist?

Given that the vast majority of hydronephrosis cases stem from structural or functional issues within the urinary tract, consulting a urologist ensures accurate diagnosis and timely intervention. These specialists use advanced imaging techniques—such as ultrasound, CT scans, and renal function tests—to identify the location and severity of the blockage.

Treatment options may include medication, minimally invasive procedures like stent placement, or surgery, depending on the root cause. Early detection and management are crucial to prevent long-term kidney damage and preserve overall urinary health.

If you're showing symptoms such as flank pain, reduced urine output, or recurrent urinary tract infections, don't delay—schedule an appointment with a urology specialist to evaluate your kidney function and rule out hydronephrosis.