A Clinical Observation on 131 Cases of Hydronephrosis

Kim, Sung Chul; Wang, Chong Soon

Abstract

Hydronephrosis is a dilatation of the collecting system of the kidney caused by obstruction to the flow of urine. Almost any type of urinary tract abnormality which leads to obstructive uropathy can eventually result in hydronephrosis; depending on the site of obstruction, the hydronephrosis may be bilateral or unilateral. If no infection is present, the dilatation of the collecting system can be of little or no clinical significance until compression and atrophy of the renal parenchyma occur. Asymptomatic or silent hydronephrosis of a lesser degree is often found in adults. Either the hydronephrotic kidney should be removed or the obstructive outlet repaired depending upon the degree of compensatory hypertrophy in the contralateral kidney. Recently, a tendency to preservation of the hydronephrotic kidney is increased by the urologist. A clinical observation was made on 131 cases of hydronephrosis during 11 years from January, 1965 to December, 1975. The results are as follows: 1. The rate of hydronephrosis accounted for 4.3% of the total patients(2995 cases) admitted to the Department of Urology. 2. The patients in this series were distributed over all ages from 6 months old female baby to 76 years old female patient. The most common age group was the 4th decades(26%). The male and female ratio was 1 : 1.2. 3. In the affected site, there was more in the left side than the right 1.2 times, 15 cases(11.5%) was bilateral. 4. In etiology, acquired ureteral stricture was most common by 46 cases(35%) and congenital UPJ stenosis was 21 cases(16 %) and etc. In children of congenital hydronephrosis(16 cases), congenital UPJ stenosis was 7 cases(43.8%) and the male and female ratio was 1.7 : 1. In 46 cases of acquired ureteral stricture, 17 cases(37 %) were due to previous operations(almost gynecologic operations in pelvic malignancies). 5. The symptoms on admission were flank pain in 72 cases(55%), hematuria 25 cases(19 %) and etc. 6. Pyuria in urinalysis was found in 61 cases(46. 6%). Urine culture was performed in 45 cases and E. coli was detected in 15 cases(33%). B.U.N. was elevated in 18 cases (13.7%) and creatinine 15 cases(11.5%). 7. Cystoscopy was performed in 109 cases. Abnormal cystoscopic findings were seen in 60 cases (55%). 8. 121 operations were performed in 103 of 131 patients. Nephrectomy and nephroureterectomy were 49 cases(40. 5%) and urinary diversion 23 cases(19%) and ureteroneocystostomy 10 cases(8. 3%) and etc. In 49 cases of nephrectomy and nephroureterectomy, 27 cases were done from January, 1965 to December. 1975. In 21 cases of congenital UPJ stenosis, 8 of 12 cases(66. 6%) were nephrectomized from January, 1965 to December, 1970 and 5 of 9 cases(55.5%) were nephrectomized from January, 1965 to December, 1975.