IP Journal of Urology, Nephrology and Hepatology Science

Management of bilateral giant hydronephrosis in the middle-age patient: a case report with review of literature

Full Text PDF

Article Type : Original Article

Author Details: Mahesh Chandra*,Keyur Parmar,Arpan Ghuman

Volume : 3

Issue : 3

Online ISSN : XXXX

Print ISSN : XXXX

Article First Page : 65

Article End Page : 67

Abstract

Giant hydronephrosis (GHN) is progressive disease caused by congenital stenosis of uretropelvic junction which usually present in early childhood. Large intraabdominal cystic lesion or distended abdomen may be only clinical sign and bilateral disease may also cause uremia in patients. If patient is febrile, uremic with elevated serum creatinine and IVU shows a non-visualized renal unit (NVK) or pelvicalyceal system is not well delineated, then ultrasound-guided percutaneous nephrostomy (PCN) should performed in emergency. Once, the patient has recovered with average daily PCN output is ? 400cc or if nuclear scan repeated at suitable interval show enough differential/split renal function (SRF) further evaluation should be done for definite management. The patients should undergo a standard pyeloplasty (Anderson-Hynes pyeloplasty) with adjunctive nephropexy for effective & dependent drainage of pyelocalyceal system. We report a case of bilateral giant hydronephrosis who presented late and successfully managed. To date, in follow-up for last 6 years, the patient is asymptomatic with no deterioration in renal function or blood pressure and his repeated urine analysis is also normal.

Keywords: Giant, Hydronephrosis, Uretropelvic, Nephrostomy, Pyeloplasty, Nephropexy.

Doi No:-10.18231