From the Research
Mild hydronephrosis often requires no specific treatment beyond monitoring and addressing the underlying cause. For asymptomatic mild hydronephrosis discovered incidentally, watchful waiting with periodic ultrasound follow-up every 3-6 months is typically recommended to ensure it doesn't worsen 1. If the hydronephrosis is caused by a urinary tract infection, antibiotics such as ciprofloxacin 500mg twice daily for 7-14 days or trimethoprim-sulfamethoxazole 160/800mg twice daily for 7-14 days may be prescribed. For kidney stones causing obstruction, pain management with NSAIDs like ibuprofen 400-600mg every 6 hours or narcotic analgesics may be needed, along with increased fluid intake of 2-3 liters daily to help pass the stone. In pregnant women, where hydronephrosis is common due to uterine compression of the ureters, left-side sleeping position and adequate hydration are recommended. The goal of treatment is to prevent kidney damage by relieving obstruction and preserving renal function. Some key points to consider in the management of mild hydronephrosis include:
- Monitoring for signs of worsening hydronephrosis or development of symptoms such as severe pain, fever, or declining kidney function.
- Addressing the underlying cause of hydronephrosis, whether it be a urinary tract infection, kidney stone, or other condition.
- Considering more aggressive interventions like ureteral stent placement or nephrostomy tube insertion if hydronephrosis worsens or becomes symptomatic. It's also important to note that the severity of hydronephrosis can be challenging to determine, and different grading systems may be used, such as the SFU or Onen grading systems 2. However, the most recent and highest quality study on this topic is from 2020, which provides an overview of hydronephrosis in adults and discusses the importance of prompt diagnosis and treatment to prevent kidney damage 1. Overall, the treatment of mild hydronephrosis should be individualized based on the underlying cause and severity of the condition, as well as the patient's overall health and medical history.