The Diagnosis of Obstructive Hydronephrosis with Color Doppler Ultrasound

Abstract

Background:The obstructive hydronephrosis is a term that implicates the structural and functional changes of the kidneys as a result of difficulties in the flow of urine. Hydronephrosis specifically describes dilation and swelling of the kidney. Hydronephrosis is a condition that typically occurs when the kidney swells due to the failure of normal drainage of urine from the kidney to the bladder. Our aim was to evaluate the degree of hydronephrosis, causes and diagnostic method. Material andMethods:This is a study of 136 patients that have been treated at the Department of Urology, University Clinical Centre of Kosovo, Prishtina. For diagnosis of hydronephrosis in our patient, we used as equipment the Color Doppler ultrasound, with resolution of 3.5 MHz–8 MHz.Results:Out of 136 participants in the study, 91 (66.9%) were males and 45 (33.1%) females, with significant difference (P=0.000). The average age for males was 49 years old, whereas for females was 33. This study included patients with a diagnosis of symptomatic hydronephrosis with various causes and degrees. All patients were presented with hydronephrosis. The hydronephrosis grade varied from the stage I up to the IV. In our study we have difference grade of hydronephrosis, X2 test, P= 0.114. The most common causes of hydronephrosis in our study were; kidney stone, ureteral stones, neck stenosis PU, pregnancy, infiltrating bladder cancer, bladder neck contracture, prostate adenoma, infiltrating prostatic carcinoma etc. In this study we have indentified different causes, of which stones dominate as the most usual causes of hydronephrosis P= 0.0001.Conclusion:The Ultrasound is an easy method to be applied, non invasive, and a fast one to help and diagnose the obstructive hydronephrosis. The ultrasound has a high sensitivity and should be used as a screening method followed by other methods, as necessary. Hydronphrosis is most commonly presented to men with an average age about fifties. We came to the conclusion that the main causes of hydronephrosis are kidney stone, followed by ureteral stones, in which, in a larger percentage, they appear with the II degree of hydronephrosis.

Association between grades of Hydronephrosis & detection of urinary stones by ultrasound imaging

“…Distribution of the grades of hydronephrosis in this study is similar to a previous survey of Nuraj P et al (2017), who reported that the grades of hydronephrosis were as follows: 48%grade 2, 22.8% grade 1, 16.2% grade 3 and 12.5% grade 4. 10 In this study, there are significant associations between the stone length and location with the grade of hydronephrosis whereas the patient’s gender has no relationship with the grade. These results are consistent with a previous study by Song Y et al (2015) regarding the stone length and patient’s gender but not compatible with him regarding the stone location.…”

“…This result is compatible with previous studies by Hall (2009) and Nuraj P et al (2017), who reported that renal calculi in males were nearly twice as it was in females. 9 , 10 …”

A clinical study on management of hydronephrosis detected antenatally

“…Nuraj P et al studied 136 cases and found that majority were males. 7 Authors also found that males were more than females. The mean age of the males was also more than females.…”

“…The authors praised the utility of USG. 7 Orabi M et al studied 105 cases of hydronephrosis and found that the majority were males. 8 Authors also found that males were more than females.…”

Auxiliary Diagnosis of Hydronephrosis Based on Ultrasound Image Dynamic Enhancement Technique

“…In recent years, with the advancement of inspection technology, magnetic resonance imaging (MRI) can not only provide more morphological information than ultrasound, but also computer-assisted post-processing technology can objectively quantify its functional assessment and classify obstruction like DRS [1]. At present, there is still a certain deficiency in the quantitative analysis of renal function by MR urography (MRU).…”