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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).
It is the most common cause of hydronephrosis detected in utero and is the most common anomaly detected on prenatal ultrasounds. [1] [2] It occurs in approximately 1 in every 1500 live births, is most commonly seen in males, involves the left ureter twice as often as the right ureter. [1] [2] UPJ obstruction is transient in most cases. [2]
A number of factors can influence its efficacy, including chemical composition of the stone, presence of anomalous renal anatomy and the specific location of the stone within the kidney, presence of hydronephrosis, body mass index, and distance of the stone from the surface of the skin. [108]
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.
Hydronephrosis is seen as an anechoic fluid-filled interconnected space with enhancement within the renal sinus, and normally, the dilated pelvis can be differentiated from the dilated calyces. [1] Figure 13. Hydronephrosis due to ureteropelvic junction obstruction in a pediatric patient. [1] Several conditions can result in urinary obstruction.
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 most relevant assessments in a renal ultrasound are renal sizes, echogenicity and any signs of hydronephrosis. Renal enlargement usually indicates diabetic nephropathy, focal segmental glomerular sclerosis or myeloma. Renal atrophy suggests longstanding chronic renal disease. [citation needed]
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.