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International Journal of Recent Trends in Science and Technology, ISSN 2277-2812 E-ISSN: 2249-8109

Volume 10, Issue 3, April 2014 pp 438-446

Research Article

Clinical Study of Unilateral or Bilateral Noncalculus Hydronephrosis and or Hydroureter

Kasabe P.¹, R. D. Jaykar², Rahul Wagh³

{¹Assistant Professor,² Associate Professor, ³ Resident}

Academic Editor : Dr. Aher K.R.

Background: Hydronephrosisis the dilation of the renal pelvis or calyces. Although patients usually presents with some signs and symptoms it can be clinically silent and is diagnosed as an incidental finding during evaluation of an unrelated cause. Although calculus is the commonest cause of hydronephosis and hydroureter there are multiple noncalculus aetiology for the same depending on the age and sex of the patient. This study is aimed towards meticulous implementation of the accurate diagnostic tools for early evaluation of noncalculus hydronephrosis and or hydroureter and to assess the effectiveness of the early treatment towards the renal function sparing. Methods: In this prospective clinical study of 50 patients of hydronephrosis and or hydroureter of all age groups and both the genders admitted in the department of surgery over a period of two years from Dec 2011 to Aug 2013 were studied. All the patients were evaluated with detail clinical history followed by thorough clinical examination and relevant investigations were done in each case. All the patients with calculus were excluded from the study. Results: Incidence of various condition leading to hydronephrosis was Puj obstruction 38% BPH 22% Vesicoureteric reflux 16% Neurogenic bladder 2% Stricture urethra 4% Retroperitoneal mass 6% B.o.o. 2% Gravid uterus 8% Ureteric stricture 2%. Conclusion: PUJ Obstruction is a most common cause of noncalculus hydronephrosis. Noncalculus hydronephrosis and or hydroureter was most common in 1^st decade of life. Incidence noncalculus hydronephrosis and or hydroureter was more common in males than females. In our study unilateral involvement is more common than bilateral. PUJ Obstruction is the most common cause of unilateral noncalculus hydronephrosis while BEP is the most common cause of bilateral noncalculus hydronephrosis and or hydroureter. Dismembered pyeloplasty is a procedure of choice in patients with PUJ Obstruction with good post-operative recovery in renal function. TURP is the gold standard for the surgical management of BPH. Early surgical intervention was associated with improved outcome in all the patients with noncalculus hydronephrosis and or hydroureter. Conservative management of hydronephrosis during pregnancy was associated with good outcome. Ultrasound is the most important baseline investigation in evaluation of patients with hydronephrosis.