Does hydronephrosis always indicate obstruction

Does hydronephrosis always indicate obstruction?

Mild hydronephrosis found on ultrasound can be a normal physiologic variant; kidney ultrasonography is therefore associated with a high false-positive rate (~24%) in detecting obstruction.

Another common “false positive” ultrasonographic finding is hydronephrosis of pregnancy, which is physiologic and rarely clinically significant.

This is hypothesized to result from both hormonal changes (elevated progesterone) influencing the ureter and mechanical extrinsic compression on the ureter from the uterus.

Hydronephrosis of pregnancy is more common in the right kidney because the sigmoid colon occupies space within the left pelvis and pushes the uterus toward the right ureter.

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