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Moderate to severe hydronephrosis R kidney
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Moderate to severe hydronephrosis R kidney

  I am a 28 year old female. I am 22 weeks pregnant. Have had ultrasoundx2, IVP, CAT scan and radionucleide scan all this during pregnancy (did not know I was pregnant). I have been diagnosed w/moderate to severe hydronephrosis on my right kidney. Pain is tremendous at times. Urologist suggests direct urinary diversion or stent. "THEY" are not 100% but they think that my uterus was enlarged to begin with and was pressing on ureter. Suggestion is now that the baby is getting bigger, more pressure is applied to ureter and causes hydronephrosis to be more severe. Is this a possibility? Very concerned about everything. None of the tests showed any obstruction. Dr. is also concerned w/left flank pain that has recently started. Can you give me any insight or suggestions?Have also become slightly incontinent. This is my 4th child and this has never happened.
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Dear Tracy,
There are some specific changes that occur during pregnancy that affect the urinary tract.  The Ureters which are dilated and called hydronephrotic, increase in size approx. 1 cm due to increased renal vascular and interstial volume during pregnancy.  The collecting system and ureters during this time also decrease there ability to peristals(contract), resulting in dilation.  The change usually occur in the second trimester and subsides after delivery.  Your right, there often is not a true obstruction but rather an external obstruction, the size of the uterus and its position can cause this dilation.  Often position changes will help the uterus fall away from the ureters and decrease your pain and pressure.
If you continue to have pain, or ever get an infection, this could be potentially dangerous to your child.  This could lead to a premature delivery.  A stent is a reasonable option.  Discuss the options with your doctor, I think he or she knows what is right.
This information is provided for general medical educational purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.  More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword:Hydronephrosis





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