Navigate Up

Pediatric Center - A-Z Index

#
Q
Z

Print This Page

Bilateral hydronephrosis

Bilateral hydronephrosis is the enlargement of the parts of the kidney that collect urine. Bilateral means both sides.

Alternative Names

Hydronephrosis - bilateral

Causes, incidence, and risk factors

Bilateral hydronephrosis occurs when urine is unable to drain from the kidney into the bladder. Hydronephrosis is not itself a disease. It occurs as a result of a problem that prevents urine from draining out of the kidneys, ureters, and bladder.

Disorders associated with bilateral hydronephrosis include:

  • Acute bilateral obstructive uropathy - sudden blockage of the kidneys
  • Bladder outlet obstruction - blockage of the bladder that does not allow drainage
  • Chronic bilateral obstructive uropathy - a gradual blockage of the kidneys
  • Neurogenic bladder - poorly functional bladder
  • Posterior urethral valves - flaps on the urethra that causes poor emptying of the bladder (in boys)
  • Prune belly syndrome - poorly emptying bladder that causes distention of the belly
  • Retroperitoneal fibrosis - increased scar tissue that blocks the ureters
  • Uteropelvic junction obstruction - blockage of the kidney at the point where the ureter enters the kidney
  • Vesicoureteric reflux - backup of the urine from the bladder up to the kidney

Symptoms

Signs of the problem are often detected in a baby before birth during a pregnancy ultrasound.

A urinary tract infection in a newborn baby can signal a blockage in the kidney. An older child who gets repeat urinary tract infections should also be checked for blockage.

A higher than normal number of urinary tract infections is often the only symptom of the problem.

Signs and tests

The following tests can show bilateral hydronephrosis:

Treatment

Placing a tube into the bladder (Foley catheter) may open the blockage. Other treatments include:

  • Draining the bladder
  • Relieving pressure by placing tubes in the kidney through the skin
  • Placing a tube (stent) through the ureter to allow urine to flow from the kidney to bladder

The underlying cause of the blockage needs to be found and treated once the buildup of urine is relieved.

Expectations (prognosis)

Surgery performed while the baby is in the womb or shortly after birth can have good results in improving kidney function.

Complications

Kidney damage may result from conditions that cause hydronephrosis.

Calling your health care provider

This problem is often found by the health care provider.

Prevention

An ultrasound during pregnancy can show a blockage in the baby’s urinary tract. This allows the problem to be treated with early surgery.

Other causes of blockage such as kidney stones can be detected early if people notice warning signs of kidney problems.

References

Singh I, Strandhopy JW, Assimos DG. Pathophysiology of urinary tract obstruction. In: Wein AJ, ed.Campbell-Walsh Urology. 10th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 40.

Hsu THS, Nakada SY. Management of upper urinary tract obstruction In: Wein AJ, ed.Campbell-Walsh Urology. 10th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 41.

Frokiaer J, Zeidel ML. Urinary tract obstruction. In: Taal MW, Chertow GM, Marsden PA et al. eds. Brenner and Rector's The Kidney. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 37.

Elder JS. Obstruction of the urinary tract. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 534.

Updated: 5/7/2013

Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.


©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

© UPMC
Pittsburgh, PA, USA UPMC.com