Hydronephrosis

  1. General information
    1. Collection of urine in the renal pelvis due to obstruction to outflow
    2. Obstruction most common at ureteral-pelvic junction (see The Genitourinary System - Vesicoureteral Reflux, in Unit 5) but may also be caused by adhesions, ureterocele, calculi, or congenital malformation
    3. Obstruction causes increased intrarenal pressure, decreased circulation, and atrophy of the kidney, leading to renal insufficiency
    4. May be unilateral or bilateral; occurs more often in left kidney
    5. Prognosis good when treated early
  2. Medical management: surgery to correct or remove obstruction
  3. Assessment findings
    1. Repeated UTIs
    2. Failure to thrive
    3. Abdominal pain, fever
    4. Fluctuating mass in region of kidney
  4. Nursing interventions: prepare child for multiple urologic studies (see The Genitourinary System - Vesicoureteral Reflux, in Unit 5).

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