A Comparative Analysis of Adult Hydronephrosis at a Tertiary Care Hospital: Uncovering Uncommon Etiologies

Background: Hydronephrosis, characterized by the swelling of a kidney due to urine buildup, presents varied clinical manifestations and etiologies. Understanding these variations is crucial for effective diagnosis and management. Objective: This study aimed to analyze the clinical characteristics and associated pathologies of hydronephrosis in a diverse patient population to enhance the understanding and management of this condition. Methods: A cross-sectional study was conducted at the surgical ward of Mardan Medical Complex and Teaching Hospital from July 2022 to July 2023. A total of 178 patients were included, with a median age of 38 years, exhibiting a slight female predominance. Non-probability sampling was used for patient selection. Criteria excluded patients with conditions like diabetes, hypertension, or cancer. Data on clinical characteristics, including lateralization, nature of hydronephrosis, and associated pathologies, were collected and analyzed using Chi-square analysis in SPSS version 24. Results: The study found that bilateral hydronephrosis was more prevalent (69%) than unilateral, with a higher incidence of left-sided (62%) involvement. Complete hydronephrosis was observed in 74% of patients, and internal hydronephrosis in 67%. Associated pathologies included urethral strictures (11%) and bladder tumors (2%). The weight distribution varied, with the most common range being 61-70 kg. Conclusion: The study highlighted the diverse presentation of hydronephrosis in adult patients, with a significant prevalence of complete and bilateral cases. These findings underscore the importance of individualized diagnostic and treatment approaches, emphasizing the need for early intervention. The study also calls for further research to understand the regional variations and underlying causes of hydronephrosis.