I am 27 years old and have also been diagnosed with hydronephrosis in my right kidney, 2 cm AP (whatever that means) in addition to urolithiasis in the gallbladder. According to the ultrasound description, there are no stones there. I would like to know what the treatment in this situation looks like and whether natural delivery will not worsen my he alth. I don't have any stomach aches or kidney problems because of this.
Hydronephrosis should be assessed on the basis of two tests - ultrasound and scintigraphy. Ultrasound examination, safe during pregnancy, informs us about the enlargement of the pelvis and the thinning of the parenchymal layer of the kidney. A one-time ultrasound examination showing the AP pelvis size of 2 cm only indicates that something is starting to happen to the kidney and we need to increase our vigilance. The enlargement of 2 cm is small and we should practically not talk about hydronephrosis, but rather about the enlargement of the pelvis, especially if it is not accompanied by a thinning of the renal cortex. In pregnancy, hydronephrosis of the pelvis of one of the kidneys may be caused by pressure on the pregnant uterus. Two or three times the ultrasound examination showing a constant increase in the size of the pelvis indicates the development of hydronephrosis and then, in combination with other appearing symptoms, we can consider surgical treatment. The second test I mentioned - kidney scintigraphy - provides information about the degree of damage to the renal parenchyma and about the emptying of the pelvis of urine. To sum up: good kidney function in a scintigraphic examination, even with impaired emptying of the pelvis and 2 cm dilation of the pelvis in the AP dimension, in the absence of symptoms, urinary tract infections, is not an indication for surgical treatment, but only observation. Unfortunately, scintigraphy cannot be performed during pregnancy.
Remember that our expert's answer is informative and will not replace a visit to the doctor.
Lidia Skobejko-WłodarskaSpecialist in pediatric urology and surgery. She obtained the title of European specialist in pediatric urology - fellow of the European Academy for Pediatric Urology (FEAPU). For many years he has been dealing with the treatment of bladder and urethral dysfunction, especially neurogenic vesico-urethral dysfunction (neurogenic bladder) in children, adolescents and young adults, using for this purpose not onlypharmacological and conservative, but also operational. She was the first in Poland to start large-scale urodynamic tests, allowing to determine the function of the bladder in children. He is the author of many works on bladder dysfunction and urinary incontinence.
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