Classification of hydroureteronephrosis by ultrasonography findings

A complex examination including blood and urine biochemistry, pyelomanometry, x-ray-radionuclide and endoscopic investigations of the urinary tract as well as ultrasonography with estimation of morphometric and functional parameters of different parts of the urinary tract was conducted in 525 patients with various diseases of the pelvic ureter and urinary bladder complicated by hydroureteronephrosis (HUN) and 50 healthy controls. The findings made it possible to distinguish four stages of HUN: hyperkinetic, dyskinetic, hypokinetic and akinetic. This gradation rests on the results of sonographic assessment of morphofunctional condition of the urinary tract which were compared with findings of the other methods of urological examination.The proposed 4-stage HUN classification based finally only on ultrasonography data describes not only severity of anatomic changes but, indirectly, functional reserves of the upper urinary tract. Sonography is an available, non-invasive, cost-effective method without contraindications. This allows recommendation of this HUN classification for wide application. According to the stage of urodynamic disorder, therapeutic policy is proposed.

ultrasonography, hydroureteronephrosis, upper urinary tract, vesicoureteral segment