Bilateral Hydronephrosis - Etiology & Imaging

Bilateral Hydronephrosis: Etiology and Imaging  


Bilateral hydronephrosis means dilatation of the bilateral collecting system, renal pelvis and ureters.

It develops due to urinary obstruction. Renal stone is the most common cause. 

Ultrasound is the first imaging modality of choice to screen. 

CT Urography is the best investigation, subject to renal functions are within normal limits. 

MR Urography is a good investigation in the pediatric age group and those who have compromised renal functions. 

MCU (micturating Cysto uretherogram), is most commonly done in pediatric population to demonstrate VUR. 


Various causes: 

1. Vesico ureteral reflux (VUR)

2. Bladder outlet obstruction - Prostatomegaly / urethral stricture / prostatic uretheral calculus / urethral mass / posterior urethral valves

3. Over distended bladder

4. Cystocele

5. Bladder mass with involvement of both VUJ

6. Neurogenic bladder

7. Post op after neo-bladder reconstruction

8.  Retroperitoneal mass or other malignant mass

9. Deep Endometriosis

10. Bilateral ureteric calculus

11. Bladder exstrophy


Prepared by Dr. Sharad Maheshwari

10.11.2022

Updated: 08.04.2023


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