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Hydronephrosis - etiology

2017-03-01 11:46

1 congenital obstructive causes

(1) segmental function due to ureteropelvic junction or upper ureteral segmental muscle agenesis and hypoplasia or anatomical structure disorder, affecting the normal peristalsis of the ureter, causing obstruction of power. Such lesions, such as at the entrance of the ureter and bladder, form a congenital ureter, which results in the expansion of the kidney and ureter.

(2) intrinsic ureteral stricture occurs mostly at the junction of the pelvis and ureter, and the stenosis is usually from 1 to 2mm, which can be as long as 1 ~ 3cm, resulting in incomplete obstruction and secondary distortion. Under the electron microscope, excessive collagen fibers can be seen in the middle of the obstructed segment muscle cells and around cells, long muscle cells are damaged, the formation of stenosis mainly collagen inelastic hinders urine transmission. Hydronephrosis.

(3) ureteral distortion, adhesion, band or PEG structure for this valve may be congenital, acquired, at the junction of the lumbar ureter in renal pelvis and ureter often occurs in children and infants, accounted for almost 2/3.

(4) ectopic vascular compression at the ureteropelvic junction in front of the other, with a horseshoe kidney and kidney during embryonic development hindered rotation etc..

(5) high ureteral opening can be congenital, but also because of peripelvic renal fibrosis or vesicoureteral reflux caused by asymptomatic hydronephrosis, cause ureteropelvic junction sites relative to the transfer in the operation can not be found stenosis.

(6) congenital ureter ectopia, cyst, double ureter.

2 acquired obstruction

(1) inflammation or ischemic scar leads to local fixation.

(2) ureteral reflux caused by ureteral distortion, coupled with fibrosis around the ureter, eventually formed the ureteropelvic junction or ureteral obstruction.

(3) a new tumor of the kidney pelvis and ureter, such as tumor, polyp, and so on.

(4) ectopic kidney.

(5) scar stenosis after trauma and trauma.

3 obstruction caused by external causes

It mainly includes the focus of the artery and vein, the pathological changes of the female genital system, the tumor and inflammation of the pelvic cavity, and the pathological changes of the gastrointestinal tract.

4 urinary tract obstruction caused by various diseases

Such as benign prostatic hyperplasia, bladder neck contracture, urethral stricture, tumor, stones and even in phimosis, also can cause urinary tract emptying difficult formed hydronephrosis.


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