Hydronephrosis refers to swelling of the kidney due to urine buildup. In children, it may be present at birth (congenital) or develop later due to urinary tract obstructions, reflux, or infections. If not addressed in time, hydronephrosis can lead to pediatric UTI, bedwetting, foul-smelling urine, and even permanent kidney damage — making early diagnosis and treatment at a pediatric urology clinic in Nagpur critical.
What Is Hydronephrosis?
- A condition where urine flow is blocked, causing it to back up into one or both kidneys
- Leads to kidney swelling and potential damage over time
- Can be detected prenatally via ultrasound or later due to symptoms
Types of Hydronephrosis
- Congenital (Antenatal) Hydronephrosis – Present at birth, detected via fetal ultrasound
- Acquired Hydronephrosis – Develops due to postnatal causes like stones or infections
- Unilateral or Bilateral – Depending on whether one or both kidneys are affected
Causes of Hydronephrosis in Children
- Ureteropelvic junction (UPJ) obstruction – Blockage where the kidney meets the ureter
- Vesicoureteral reflux (VUR) – Urine flows backward from bladder to kidneys
- Posterior urethral valves (PUV) – Congenital bladder outlet obstruction in boys
- Kidney stones (child nephrolithiasis)
- Pediatric UTI, especially if recurrent or poorly treated
- Neurogenic bladder or dysfunctional voiding
Symptoms to Watch For
- Abdominal pain or flank discomfort
- Swelling or mass felt in the belly
- Foul-smelling urine
- Painful urination (dysuria)
- Recurrent pediatric UTIs
- Bedwetting or urinary incontinence
- Child fever, chills, or vomiting during infection
- Poor growth or feeding issues in infants
Many children with hydronephrosis may be asymptomatic in early stages and discovered only through imaging.
Diagnosis and Evaluation
- Ultrasound (prenatal and postnatal) – First-line imaging to detect swelling
- Voiding cystourethrogram (VCUG) – To check for reflux
- Diuretic renal scan (DTPA/MAG3) – To assess kidney drainage and function
- Urine culture and analysis – To rule out UTI, especially if symptoms like foul-smelling urine or bedwetting are present
For suspected or diagnosed hydronephrosis, referral to a specialized pediatric nephrology and urology clinic is vital.
Treatment Options
Observation
- For mild cases detected in fetal ultrasound or with no symptoms
- Regular monitoring through imaging
- Parents educated on signs of infection or obstruction
Medications
- Antibiotic prophylaxis to prevent recurrent UTIs
- Pain management if kidney stones or infection occurs
Surgical Intervention
Required in moderate to severe cases, including:
- Pyeloplasty – To relieve UPJ obstruction
- Ureteral reimplantation – For severe reflux
- Valve ablation – In posterior urethral valves (PUV)
- Stone removal in child nephrolithiasis
All procedures aim to preserve kidney function and prevent further damage.
Post-Treatment Care
- Continued follow-up with pediatric urologist
- Periodic ultrasound or renal scans
- Urine tests to monitor for pediatric UTI, bedwetting, or painful urination
- Long-term bladder training or behavioral therapy if voiding dysfunction is present
When to Consult a Pediatric Urologist in Nagpur
See a pediatric urologist like Dr. Sadashiv Bhole if your child has:
- Prenatal diagnosis of hydronephrosis
- Recurrent UTIs, foul-smelling urine, or child fever
- Difficulty urinating, dysuria, or bedwetting
- Kidney swelling detected on ultrasound
- Family history of congenital urological disorders
Hydronephrosis is a condition that may start silently but can cause significant damage if ignored. From newborns with prenatal swelling to children with bedwetting, UTI, or painful urination, early diagnosis and treatment by a specialist is key.
If your child shows any signs of urinary issues or kidney swelling, consult a pediatric urologist like Dr. Sadashiv Bhole to ensure the best outcome. Timely care can preserve kidney function, improve quality of life, and ensure your child grows up healthy and strong.
