Hydronephrosis: Causes and Management Strategies

Q: Hydronephrosis: Causes and Management Strategies

Hello： The information provided here is for reference only and cannot replace a physician's examination, testing, or diagnosis. <br><br>1) For right renal hydronephrosis, it is recommended to go to the hospital for further evaluation, as the urine shows no abnormalities. <br>It i

Causes and Management of Hydronephrosis

Hello Doctor: I am currently 29 years old, 153 cm tall, and weigh 53 kg.
Recently, I have been experiencing severe cramping pain in my lower abdomen, often to the point of breaking into a cold sweat, which led me to visit a gynecologist.
The gynecologist found no issues and recommended that I see a urologist.
During my visit to the urologist, my urine tests came back normal, showing no signs of inflammation or hematuria.
However, an ultrasound revealed hydronephrosis in my right kidney.
What could be the causes of hydronephrosis? The doctor advised me to drink more water, but I am already consuming around 2000-3000 ml of plain water daily, along with approximately 700 ml of unsweetened coffee and tea.
To prevent urinary tract infections, I am also taking D-mannose.
Are there any other methods to alleviate these symptoms? Additionally, are there patients in clinical practice who experience hematuria simply from exercising? Recently, whenever I go to the gym and intensify my abdominal workouts, I notice blood in my urine the next day, which is quite distressing.
Thank you, Doctor, for your hard work.

Miss Wang, 20~29 year old female. Ask Date: 2021/10/01

Dr. Du Shixi reply Urology

Hello: The information provided here is for reference only and cannot replace a physician's examination, testing, or diagnosis.

1) For right renal hydronephrosis, it is recommended to go to the hospital for further evaluation, as the urine shows no abnormalities.
It is highly likely that this is merely a slight dilation of the renal collecting system, not caused by a disease.
This condition can be considered safe and is not abnormal.
2) Additionally, are there patients who experience hematuria simply from exercising? Recently, whenever I go to the gym and intensify my abdominal workouts, I notice blood in my urine the next day, which is quite distressing.
--> This is not normal.
There are indeed such cases, although they are rare.
If examinations confirm that the visible hematuria is caused by certain exercises, my personal opinion is to avoid such activities.
Wishing you good health.

Reply Date: 2021/10/01

More Info

Hydronephrosis is a condition characterized by the swelling of a kidney due to a build-up of urine. This occurs when there is an obstruction in the urinary tract that prevents urine from draining properly from the kidney to the bladder. Understanding the causes and management strategies for hydronephrosis is crucial, especially in your case, where you are experiencing significant abdominal pain and have been diagnosed with hydronephrosis in your right kidney.

Causes of Hydronephrosis
1. Obstruction: The most common cause of hydronephrosis is an obstruction in the urinary tract. This can be due to kidney stones, tumors, or strictures (narrowing of the ureter). In some cases, congenital abnormalities can lead to blockages.

2. Reflux: Vesicoureteral reflux, where urine flows backward from the bladder into the kidneys, can also cause hydronephrosis.

3. Infection: Urinary tract infections (UTIs) can lead to swelling and inflammation, which may obstruct urine flow.

4. Pregnancy: In women, the growing uterus can compress the ureters, leading to hydronephrosis.

5. Neurological Conditions: Conditions that affect nerve signals to the bladder can lead to urinary retention and hydronephrosis.

Management Strategies
1. Hydration: As your doctor suggested, staying well-hydrated is essential. Drinking adequate amounts of water helps dilute the urine and can prevent the formation of kidney stones, which may be contributing to the obstruction.

2. Dietary Adjustments: Reducing salt intake can help minimize fluid retention and pressure on the kidneys. Additionally, a diet low in oxalates (found in foods like spinach and nuts) may help if you are prone to kidney stones.

3. Regular Monitoring: Regular follow-ups with your urologist are important to monitor the condition of your kidneys and the status of any obstruction.

4. Pain Management: Over-the-counter pain relievers may help manage the discomfort associated with hydronephrosis. However, consult your doctor before taking any medication.

5. Surgical Intervention: If the obstruction is severe or persistent, surgical options may be necessary to relieve the blockage. This could involve procedures to remove stones, repair strictures, or bypass the obstruction.

Exercise and Blood in Urine
Regarding your concern about experiencing hematuria (blood in urine) after exercising, it is not uncommon for some individuals to notice blood in their urine following intense physical activity, especially if they are engaging in high-impact exercises or activities that put strain on the abdominal area. This can be due to:
- Rhabdomyolysis: A condition where muscle tissue breaks down and releases myoglobin into the bloodstream, which can then be filtered by the kidneys, leading to hematuria.

- Bladder Irritation: Intense exercise can irritate the bladder and lead to bleeding.

- Dehydration: Even with high fluid intake, if you are not adequately hydrating before and during exercise, it can lead to concentrated urine and irritation.

Recommendations
1. Modify Exercise Routine: Consider adjusting your workout intensity or type of exercise. Low-impact activities may be less likely to cause irritation.

2. Hydration During Exercise: Ensure you are drinking water before, during, and after your workouts to stay hydrated.

3. Consult a Urologist: If blood in your urine persists, it is essential to consult a urologist for further evaluation. They may recommend imaging studies or other tests to determine the underlying cause.

4. Avoid Irritants: Limit caffeine and alcohol, as they can irritate the bladder.

In conclusion, while hydronephrosis can be concerning, understanding its causes and management strategies can help you navigate this condition effectively. Regular follow-ups with your healthcare provider and making lifestyle adjustments can significantly improve your symptoms and overall kidney health.

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