Radiography Intravenous Urography There is limited evidence to support the use of radiography with IVU (also referred to as IVP) for initial imaging of patients with asymptomatic bilateral hydronephrosis or asymptomatic hydronephrosis in a solitary kidney with unknown cause. US Abdomen There is relatively limited evidence to support the use of US of the abdomen for initial imaging of patients with asymptomatic bilateral hydronephrosis or asymptomatic hydronephrosis in a solitary kidney with unknown cause. Although US allows evaluation for increased renal echogenicity, which is nonspecific, but can be helpful in assessing for chronic kidney disease, US abdomen is a less comprehensive examination of the genitourinary system than CT, MRU, renal scintigraphy, or US color Doppler kidneys and bladder retroperitoneal. US Color Doppler Kidneys and Bladder Retroperitoneal Although there is limited evidence to support the use of US of the abdomen for initial imaging of patients with asymptomatic bilateral hydronephrosis or asymptomatic hydronephrosis in a solitary kidney with unknown cause, it may be useful in this setting in some clinical situations. Although renal US can identify and grade hydronephrosis, it is less useful for identification of etiology. US does allow evaluation for increased renal echogenicity, which, although nonspecific, can be helpful in assessing for chronic kidney disease. Additionally, US Color Doppler kidneys and bladder retroperitoneal allows evaluation of ureteral jets, bladder distension, and postvoid residual bladder volume and can allow measurement of the prostate to evaluate for prostatomegaly. Elevation of resistive indices is nonspecific but can be seen in the setting of obstruction. However, more comprehensive evaluation can often be achieved with CT, MRU, or renal scintigraphy. Variant 3: Adult. Symptomatic hydronephrosis with unknown cause. Initial imaging.
Hydronephrosis on Prior Imaging Unknown Cause. Radiography Intravenous Urography There is limited evidence to support the use of radiography with IVU (also referred to as IVP) for initial imaging of patients with asymptomatic bilateral hydronephrosis or asymptomatic hydronephrosis in a solitary kidney with unknown cause. US Abdomen There is relatively limited evidence to support the use of US of the abdomen for initial imaging of patients with asymptomatic bilateral hydronephrosis or asymptomatic hydronephrosis in a solitary kidney with unknown cause. Although US allows evaluation for increased renal echogenicity, which is nonspecific, but can be helpful in assessing for chronic kidney disease, US abdomen is a less comprehensive examination of the genitourinary system than CT, MRU, renal scintigraphy, or US color Doppler kidneys and bladder retroperitoneal. US Color Doppler Kidneys and Bladder Retroperitoneal Although there is limited evidence to support the use of US of the abdomen for initial imaging of patients with asymptomatic bilateral hydronephrosis or asymptomatic hydronephrosis in a solitary kidney with unknown cause, it may be useful in this setting in some clinical situations. Although renal US can identify and grade hydronephrosis, it is less useful for identification of etiology. US does allow evaluation for increased renal echogenicity, which, although nonspecific, can be helpful in assessing for chronic kidney disease. Additionally, US Color Doppler kidneys and bladder retroperitoneal allows evaluation of ureteral jets, bladder distension, and postvoid residual bladder volume and can allow measurement of the prostate to evaluate for prostatomegaly. Elevation of resistive indices is nonspecific but can be seen in the setting of obstruction. However, more comprehensive evaluation can often be achieved with CT, MRU, or renal scintigraphy. Variant 3: Adult. Symptomatic hydronephrosis with unknown cause. Initial imaging.