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Hydronephrosis describes hydrostatic dilation of the renal pelvis and calyces as a result of obstruction to urine flow downstream. Alternatively, hydroureter describes the dilation of the ureter, and hydronephroureter describes the dilation of the entire upper urinary tract (both the renal pelvicalyceal system and the ureter).
Ureterovesicular junction obstruction (UVJ obstruction) is an obstruction at the level of the ureter and bladder. It accounts for 20% of cases of hydronephrosis detected in utero. It is also most commonly seen in males and involved both sides of the urinary tract in approximately 25% of cases. [1]
Prenatally diagnosed hydronephrosis (fluid-filled kidneys) suggest post-natal follow-up examination. The strongest neo-natal presentation is urinary tract infection.A hydronephrotic kidney may present as a palpable abdominal mass in the newborn, and may suggest an ectopic ureter or ureterocele.
Features that suggest posterior urethral valves are bilateral hydronephrosis, a thickened bladder wall with thickened smooth muscle trabeculations, and bladder diverticula. [citation needed] Voiding cystourethrogram (VCUG) is more specific for the diagnosis. Normal plicae circularis are variable in appearance and often not seen on normal VCUGs.
Abdominal ultrasound examination of the prostate and kidneys is often performed to rule out hydronephrosis and hydroureter. Incidentally, cysts, tumours, and stones may be found on ultrasound. Post-void residual volume of more than 100 ml may indicate significant obstruction. [52]
The size of the renal pelvis plays a major role in the grading of hydronephrosis. Normally, the anteroposterior diameter of the renal pelvis is less than 4 mm in fetuses up to 32 weeks of gestational age and 7 mm afterwards. [2] In adults, 13% of the normal population have a transverse pelvic diameter of over 10 mm. [3]
The fishhook ureter sign, also known as the "hockey stick" or "J-shaped" ureter sign, is a radiologic sign that has been used to describe the presence of a retrocaval ureter, which is an anatomical anomaly where the ureter abnormally runs posterior to the IVC.
Renal colic, also known as ureteric colic, is a type of abdominal pain commonly caused by obstruction of ureter from dislodged kidney stones.The most frequent site of obstruction is the vesico-ureteric junction (VUJ), the narrowest point of the upper urinary tract.