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What Causes Lower Abdominal Pain And Hydronephrosis?

Posted on Wed, 7 Jan 2015

Question: Hello Sir,
My wife has been going through pain in her lower abdomen for some days ago. Actually she have been developing it since 1 and half years ago after her gym. The pain occurred just after her urination is complete but it was not frequent. The length of the pain was not more than 20-25 seconds but it was intense. First we thought it may be caused from some minor gastric issue so we were careless but later on we went for a doctor and he referred to do a blood and urine test followed by an USG test. The blood and urine test came normal but in USG, it came as hydronephrosis in her right kidney. To ensure that doctor made her to go through two more test which are X-RAY KUB and IVP test. The test came all normal result except her "right renal pelvic fullness". No sign of stone whatsoever. The inflammation of the renal pelvic was 10mm. So my question is it something serious?? What's causing the inflammation? Is it something to be scared about?

Answered by Dr. Deepak Kishore Kaltari (8 hours later)

Brief Answer:
Likely to be due to PelviUreteric junction obstruction

Detailed Answer:
Hi
Welcome to Healthcaremagic
Greetings of the day
Dear Sir

Renal Pelvis dilatation of 10 mm is minor dilatation of renal pelvis. This dilatation could be due to two reasons

1. Obstruction at PelviUreteric (junction of kidney pelvis and ureter )

2. Vesico - ureteric reflux : There is abnormal reflux of Urine from the bladder into ureter , causing back pressure and dilatation of Kidney pelvis. This is more likely if there is Hydroureter(dilatation of Ureter ) seen in the scan .

It would be very helpful if you could provide me detailed Ultrasound report which includes following information

1. Is the corticomedullary differentiation maintained ?
2. Is there associated Hydroureter
3. Renal cortical thickness

In majority of cases it's due to PelviUreteric junction , dilatation of 10 mm is mild. It requires DTPA radionucleotide scan to rule out significant obstruction. Do get back to me with the scanned copy of all the reports

Awaiting your response

Take care

Best regards
Dr Deepak Kaltari

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Deepak Kishore Kaltari (22 hours later)

Thank you so much doctor. I've uploaded her IVP scan report. Kindly check and let me know if any further information you need.

Answered by Dr. Deepak Kishore Kaltari (1 hour later)

Brief Answer:
IVP is normal

Detailed Answer:
Dear Sir

Thanks for providing the IVP image. There is no obvious blockage at the region of renal pelvis, which is substantiated by the fact that the XXXXXXX is draining adequately into the ureter. There is no other obvious pathology seen.

The most likely cause for hydronephrosis could be impacted stone in renal pelvis which has passed out. Based on this scenario, I would suggest the following

1. Repeat Ultrasound scan after 4 weeks and early if still having symptoms

In majority of cases there will be resolution of Hydronephrosis. If there is persistent Hydronephrosis then following investigation will be needed in consultation with your Physician

1. Renal DTPA scan

2. Voiding Cystourethrogram(VCUG): especially required if the scan report reveals dilatation of ureter

Kindly let me know the Ultrasound report in detail and also let me know if your wife is still having symptoms.

Take Care

Best Regards
Dr Deepak

Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Prasad