Urologist reviewing a kidney ultrasound for hydronephrosis at a Melbourne FL urology clinic

Hydronephrosis Care in Melbourne, FL

Expert urology evaluation for kidney swelling from urinary obstruction

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Grades:Mild (Grade 1) to Severe (Grade 4)

Common Causes:Kidney stones, BPH, strictures, tumors

Common In:Adults of all ages, congenital in infants

Treatment Approach:Relieve obstruction, protect kidney function

Diagram of a swollen kidney showing hydronephrosis from urinary obstruction

Understanding the Condition

What Is Hydronephrosis?

Swelling of the kidney from blocked urine flow

At Zabinski Urology in Melbourne, FL, our urologists evaluate and manage hydronephrosis for patients across Brevard County and the Space Coast, including Palm Bay, Viera, Rockledge, Cocoa, Cocoa Beach, Merritt Island, Indialantic, Satellite Beach, and Suntree. Hydronephrosis is the swelling of one or both kidneys that develops when urine cannot drain properly from the kidney to the bladder. Catching it early protects long term kidney function.

Hydronephrosis is not a disease on its own. It is a sign that something downstream, often a kidney stone, an enlarged prostate, a ureteral stricture, a tumor, or a congenital narrowing, is blocking the flow of urine. Pressure builds inside the collecting system of the kidney, stretching the renal pelvis and calyces. If the obstruction is short lived, the kidney usually recovers. If it persists, function can be permanently lost.

Our father and son team brings more than 60 combined years of urology experience to every case. We use focused imaging, urinalysis, and procedures such as cystoscopy and bladder scans to find the cause and create a clear treatment plan. The goal is always the same: relieve the obstruction quickly and preserve the kidney.

Why It Happens

Common Causes of Hydronephrosis

What blocks urine flow and stretches the kidney

Hydronephrosis develops whenever urine flow from the kidney is interrupted. The most frequent cause in adults is a kidney stone lodged in the ureter, the narrow tube between the kidney and the bladder. According to the National Institute of Diabetes and Digestive and Kidney Diseases, roughly 1 in 11 Americans will develop a kidney stone in their lifetime, and ureteral stones are a leading reason patients arrive in emergency rooms with severe flank pain and a backed up kidney.

In men over 50, an enlarged prostate (benign prostatic hyperplasia) is another common driver. The prostate presses on the urethra, urine pools in the bladder, and pressure travels back up to the kidneys. Other causes include ureteral strictures from prior infections or surgery, bladder or pelvic tumors, pregnancy (where the growing uterus compresses the ureters), and neurogenic bladder conditions that prevent the bladder from emptying. In children, hydronephrosis is often congenital, caused by a narrowed ureteropelvic junction or vesicoureteral reflux discovered on prenatal ultrasound.

Ultrasound images comparing mild Grade 1 to severe Grade 4 hydronephrosis in a kidney

Severity Levels

Understanding the Grades of Hydronephrosis

From mild dilation to severe kidney involvement

Urologists and radiologists classify hydronephrosis by severity, usually on a scale from Grade 1 to Grade 4, sometimes described as mild, moderate, or severe. The grading helps our urologists decide how urgently to act and what to monitor.

Grade 1 (mild): The renal pelvis is slightly dilated but the kidney shape and tissue look normal on ultrasound or CT. Function is preserved. Often resolves on its own once the cause is treated.

Grade 2 (mild to moderate): The renal pelvis and a few calyces are dilated. Kidney tissue still appears normal. Closer follow up imaging is usually warranted.

Grade 3 (moderate): All calyces are dilated and the kidney is visibly enlarged. Some thinning of the kidney tissue (parenchyma) may begin. Intervention is often required to prevent damage.

Grade 4 (severe): The collecting system is markedly stretched and the kidney tissue is significantly thinned. This grade carries the highest risk of permanent function loss and often requires urgent decompression with a ureteral stent or percutaneous nephrostomy tube.

Bilateral hydronephrosis (both kidneys involved) is treated more urgently than unilateral hydronephrosis because total kidney function is at risk. Acute hydronephrosis with infection (called pyonephrosis) is a urologic emergency.

Patient holding their flank in pain, a classic symptom of acute hydronephrosis

Flank or Side Pain

Sharp, cramping pain in the back or side that may radiate to the groin, often from an obstructing stone.

Nausea and Vomiting

The kidney shares nerve pathways with the gut, so severe obstruction often triggers nausea.

Blood in the Urine

Visible or microscopic hematuria, especially when stones are the cause. Always warrants evaluation.

Urinary Frequency or Urgency

Feeling the need to urinate often, or difficulty emptying the bladder when BPH is the cause.

Fever or Chills

May signal a urinary tract infection behind the obstruction. This is an emergency.

Decreased Urine Output

Especially concerning if both kidneys are involved or you have only one functioning kidney.

Swelling of the Abdomen

More common in infants and small children with severe congenital hydronephrosis.

Our urologists at their Melbourne FL urology practice

Local Expertise

Why Choose Zabinski Urology for Hydronephrosis Care in Melbourne, FL

60+ years of combined urology experience

Board-Certified Urologists
Same-Practice Continuity
In-House Diagnostics
Strong Hospital Affiliations
Plain Language Education
Whole Urinary Tract View

Diagnostic Service	Primary Purpose	What It Detects	In-Office	Best Use Case
Cystoscopy	Direct view of the bladder and lower ureters	Tumors, stones, strictures, bladder outlet obstruction	Yes	Suspected lower tract cause of obstruction
Bladder Scans	Ultrasound measurement of urine remaining in the bladder	Incomplete emptying, post void residual elevation	Yes	BPH, neurogenic bladder, retention as a cause
Urodynamic Testing	Functional study of bladder pressure and flow	Detrusor weakness, outlet obstruction, reflux risk	Yes	Functional cause of upper tract pressure

Adult patient consulting with a urologist about kidney pain symptoms

When to See a Urologist

When You Should Seek Urology Care

Symptoms that warrant a hydronephrosis evaluation

Severe Flank or Back Pain
Known Kidney Stones
BPH or Difficulty Urinating
Recurring Urinary Tract Infections
Incidental Imaging Finding
History of Pelvic Surgery or Radiation
Prenatal or Pediatric Hydronephrosis

01 Is hydronephrosis dangerous?

It can be. Short term, mild hydronephrosis from a small passing stone is often not dangerous. However, prolonged or severe obstruction can permanently damage the kidney, and hydronephrosis combined with infection (pyonephrosis) is a urologic emergency. That is why we recommend prompt evaluation whenever it is found on imaging.

02 Can hydronephrosis go away on its own?

Yes, mild hydronephrosis frequently resolves once the underlying cause is treated. A small kidney stone may pass and the swelling decreases. Pregnancy-related hydronephrosis usually resolves after delivery. Higher grades or persistent obstruction typically need a procedure such as a ureteral stent, lithotripsy, or surgery.

03 What tests will I need at Zabinski Urology?

A typical workup starts with a focused history and physical exam, urinalysis, and a bladder scan to measure how well you empty. Depending on findings we may order or review a renal ultrasound or CT urogram, perform cystoscopy to look inside the bladder, or recommend urodynamic testing to measure bladder pressures.

04 Do I need surgery for hydronephrosis?

Not always. Treatment depends on the cause. Many patients are managed with medication, observation, or temporary stenting. Surgery becomes necessary when there is a fixed obstruction such as a large stone, a stricture, a junction narrowing, or a tumor. We discuss all options before any procedure.

05 How quickly should I be seen if I have flank pain and possible kidney swelling?

Sudden severe flank pain with nausea, fever, or visible blood in the urine should be evaluated the same day, often in an emergency room first. Once you are stabilized, we can see you quickly at our Melbourne office to plan definitive treatment and follow up imaging.

06 Can hydronephrosis affect both kidneys?

Yes. Bilateral hydronephrosis usually means the blockage is in the bladder or below, such as severe BPH, a bladder stone, a urethral stricture, or a pelvic mass. Because total kidney function is at stake, bilateral cases are treated more urgently than one-sided hydronephrosis.

07 What is the long-term outlook?

When the cause is identified and treated promptly, most patients keep normal or near-normal kidney function. Outcomes are best when the obstruction is relieved quickly and the patient is monitored with periodic imaging and kidney function tests. Our team tailors follow up to your individual case.

Location129 W Hibiscus Blvd, Suite D
Melbourne , FL, 32901

Emailinfo@zabinskiurology.com

Phone(321) 372-1372

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Scientific References

PubMed (PMID: 28045646) - Khalaf IM et al. Ultrasonographic grading of hydronephrosis and its correlation with kidney function and obstruction severity.
PubMed (PMID: 27238616) - Assimos D et al. Surgical Management of Stones: American Urological Association/Endourological Society Guideline (2016), addressing obstructing ureteral stones causing hydronephrosis.
PubMed (PMID: 29154526) - Nguyen HT et al. Multidisciplinary consensus on the classification of prenatal and postnatal urinary tract dilation (UTD classification system).
PubMed (PMID: 31626751) - Foley R et al. Outcomes of ureteral stenting versus percutaneous nephrostomy for the management of acute obstructive hydronephrosis.
PubMed (PMID: 25533341) - Riedmiller H et al. EAU guidelines on paediatric urology: congenital hydronephrosis and ureteropelvic junction obstruction management.
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) - Patient and clinician resources on kidney stones, ureteral obstruction, and hydronephrosis.
American Urological Association (AUA) Urology Care Foundation - Patient education on causes, symptoms, and treatment of hydronephrosis.

Hydronephrosis Care in Melbourne, FL

What Is Hydronephrosis?

Common Causes of Hydronephrosis

Understanding the Grades of Hydronephrosis