Ureteral Obstruction and Hydronephrosis Treatment: Experienced Specialists in New York

by Dr. Alex Shteynshlyuger, a board-certified urologist and specialist in the treatment of urinary problems in men and women including frequent urination, burning with urination and urinary retention.  


If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: 646-663-4151


What is Hydronephrosis, Ureteral Obstruction, and Hydroureter?

The ureter is a tube that connects the kidney to the bladder.  Urine flows through the ureter from the kidney where it is made to the bladder where it is stored before urination.  Normally, each person has 2 ureters: one on the right and one on the left. Each ureter connects right kidney and left kidney respectively to the bladder.  A small number of men and women are born with only one kidney and have one ureter; others lose a kidney (and ureter) to trauma or surgery.

Some patients have partially duplicated ureter or completely duplicated ureter on one side or less commonly on both sides.  As a result, rare patients with bilateral ureteral duplication may have as many as 4 ureters.

Ureteral obstruction or blockage prevents urine from passing from the kidney, where it is made, down to the bladder where it is typically stored.  As a result of ureteral obstruction, the kidney swells up with urine that it makes.  Kidney swelling with urine or dilatation of the kidney renal pelvis to be more precisely anatomically correct is called hydronephrosis.   When the blockage occurs in the ureter, usually the ureter as well as up as well as a kidney.  Dilatation of the ureter is called a hydroureter.  Dilatation of both the kidney and the ureter is cold hydroureteronephrosis but commonly hydronephrosis is used to refer to dilatation of both ureter and the kidney.

What is the Danger of Hydronephrosis?

Any process that leads to blockage of urine flow from the kidney to the bladder can cause kidney damage.  It can also predispose patients to infection and pain.  Kidneys filter out substances that are not needed in the body.  If the kidney cannot filter these substances out and get rid of them in the urine, accumulations of these substances can be dangerous and life-threatening.

Ureteral obstruction is particularly dangerous in patients with only one kidney or in patients with underlying kidney dysfunction caused by high blood pressure, diabetes or other problems.

What are the Causes of Ureteral Obstruction and Hydronephrosis?

Most common causes of ureteral obstruction and hydronephrosis are kidney stones and ureteral stones. 

Ureteral strictures or narrowing, caused by infection, scarring or injury from trauma or surgery can also cause hydronephrosis.  

Compression of the ureter by abdominal masses, large uterine fibroids, severe constipation, colon cancer, bladder cancer, prostate cancer, cervical cancer, uterine cancer and other processes can also lead to ureteral obstruction and hydronephrosis.  Lymphoma and retroperitoneal fibrosis can also cause ureteral blockage.

Urinary retention (incomplete bladder emptying) can cause non-obstructive hydronephrosis from urine backing up from the bladder up into the kidneys.

UPJ (ureteropelvic junction) obstruction is another common cause of ureteral obstruction and hydronephrosis. Usually, the cause of UPJ is thought to be congenital (people are born with it). 

Symptoms of Ureteral Obstruction and Hydronephrosis

Many patients have minimal or vague symptoms from ureteral obstruction and hydronephrosis in particular in the process is gradual and long-standing.  Patients may experience vague flank or back discomfort intermittently or constantly.  Some patients experience worsening of pain or discomfort when they drink alcoholic beverages.

In patients with obstruction caused by kidney stones, the pain is usually more acute, severe and often associated with nausea and vomiting which typically brings patients to the emergency room.

Why is Ureteral Obstruction an Urgent Problem?

Ureteral obstruction can predispose to infection and severe sepsis (systemic blood infection).  In addition, ureteral obstruction if prolonged can permanently damage kidney function which could be deadly or require hemodialysis.

In patients with cancer, prompt treatment of ureteral obstruction and hydronephrosis is important.

Treatment Options for Ureteral Obstruction

Treatment of ureteral obstruction usually involves 2 parts.  The first part of treatment is aimed at allowing kidneys to drain and functioning normally.  This can be accomplished by inserting a ureteral stent, which is a small plastic tube it is inserted inside the ureter to prop it open.  Alternatively, percutaneous nephrostomy which is a small tube that can be inserted directly into the kidney through the skin that overlies kidneys. 

The second part of treatment for ureteral obstruction is addressing the underlying cause of ureteral obstruction.  In some patients, the problem may be caused by kidney stones which may be broken at the same time that ureteral JJ stent is inserted or stones can be broken subsequently. 

In patients with ureteral strictures, appropriate treatment such as ureteral stricture repair can be performed.  In men and women with hydronephrosis from ureteral compression from cancer, treatment of underlying cancer with curative chemotherapy, surgery or radiation can address the underlying problem.

Why Choose New York Urology Specialists for Treatment of Ureteral Obstruction, Stricture and Hydronephrosis?

  • All treatment is performed by a Board-certified urologist experienced in treating men with symptoms of frequent urination, urinary urgency, urinary incontinence and bladder pain using medical therapy, minimally invasive therapies, lasers and open surgery.
  • We are one of the few practices in the region to offer a full range of options for treatment of urinary problems in men and women
  • We offer treatment options for overactive bladder, UTI, and urinary incontinence in our office which avoids the risks, costs, and recovery from general anesthesia.  
  • Extensive Experience: Hundreds of men and wo men have been treated successfully using medical therapy, Botox for overactive bladder, Interstim for frequent urination and tibial neuromodulation.

Excellence-Urology_Care VasectomyWhen it comes to experience and innovation – New York Urology Specialists are a step ahead.  Better Science Means Better Care.  We specialize in minimally invasive highly effective treatment for symptoms of bladder pain, urethral burning, pelvic discomfort, incomplete bladder emptying, urinary frequency, and urgency. Many treatment procedures are performed in the convenience and privacy of office settings under local anesthesia.

If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: 646-663-4151

 

Medicare and major insurances accepted.  We offer affordable rates and financing options.

Schedule an Appointment with Dr. Shteynshlyuger:

Call today: 646-663-4151 or make an appointment online

Dr. Alex Shteynshlyuger is a fellowship trained board-certified urologist with expertise in evaluation and treatment of urinary problems.  He uses modern effective and proven treatment methods including Botox for OAB, Interstim neuromodulation.  He is highly recommended by top primary care physicians in the New York area.

He has successfully treated hundreds of men and women of all ages with urinary problems including bladder problems, kidney problems, urethral and ureteral problems. 

If you or someone you know has been experiencing urological symptoms, make an appointment to take advantage of Dr. Shteynshlyuger’s expert advice. Please feel free to Contact Us with any questions.

 


If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: 646-663-4151

We offer affordable, highest-quality urology care with or without insurance.   Find out our office hours or directions to our office. We offer weekday, weekend, and evening office hours.


     

 

 

 

 

 

 

 


If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: 646-663-4151

Dr. Alex Shteynshlyuger is a board-certified urologist in NYC who specializes in treating men and women with urinary problems including frequent urination, difficulty emptying the bladder, urinary urgency and incontinence.