ABSTRACT Hydronephrosis is defined as aseptic distension of the renal calyces and pelvis with urine as a result of partial obstruction of the outflow of urine. It is a clinical condition which is caused by dilatation of the renal collecting system most frequently caused by incomplete or complete obstruction. Although this condition is quite common yet its incidence and prevalence, aetiology, diagnosis and management is less commonly reported in literature especially in context with adults and non-pregnant women. This prospective study was conducted to evaluate the etiology, classify causes of hydronephrosis and to study common clinical presentation of Hydronephrosis. hydronephrosis was seen as a highly male dominant disease with renal calculi as the major aetiology and BPH and VUR being age-associated risk factors. Aetiology based management of hydronephrosis yielded good outcome. The present study is perhaps the first detailed clinco-pathological profile of hydronephrosis. Rahul Bhushan, Pankaj Kumar, Sanjay Bhat Department of Surgery Era's Lucknow Medical College & Hospital, Sarfarazganj, Hardoi Road, Lucknow, U. P., India-226003 INTRODUCTION Hydronephrosis is a condition where urine overfills, or backs up, into the kidney, which causes the kidney to stretch (dilate), much like a balloon when it is filled with water (1). Hydronephrosis is defined as aseptic distension of the renal calyces and pelvis with urine as a result of partial obstruction of the outflow of urine (2). It is a clinical condition which is caused by dilatation of the renal collecting system most frequently caused by incomplete or complete obstruction. There could be a number of underlying causes of hydronephrosis including congenital blockage (present at birth, scarring of tissue (from injuries or previous surgery), calculus, tumours or cancer, vesical mass, urinary tract infection (UTI) and benign prostatic hypertension (BPH) and pregnancy (3- 4). Hypertrophy Secondary to ureteropelvic junction obstruction may present as acute severe flank pain radiating to the inguinal and genital area (5). Hydronephrosis was first studied in 1824 by Fiorep. Since that time, several investigators have studied this association and the prevalence of hydronephrosis with uterine prolapse has varied from 0% to 100%(6-7). This variation can probably be accounted for by differences in the severity of prolapse and by small patient numbers (8). Although this condition is quite common yet its incidence and prevalence, aetiology, diagnosis and management is less commonly reported in literature especially in context with adults and non-pregnant women (9). Most of the literature available is related with hydronephrosis in foetuses, neonates and children and pregnant women (10). Most of the studies in adults are case-reports or concerned only with diagnostic aspect and as such there is no comprehensive study highlighting the clinical profile, aetiology and management of hydronephrosis in adults only (11-12). In view of this void in literature, the present study was planned in which in order to maintain the exclusiveness, paediatric age group and pregnant women were excluded. It was also kept in mind that hydronephrosis in severely ill patients there might be multiple underlying aetiologies which may confound in exact evaluation of aetiologies and their diagnosis as proposed in present study; hence it was decided to exclude very sick patients with renal failure and patients with associated severe co morbid diseases (13). Patients were selected consecutively as and when they present during the study period considering the inclusion and exclusion criteria. Data for the study was collected from patients attending the Emergency/Surgery OPD in the Department of General Surgery at Era's Lucknow Medical College and Hospital, Lucknow. The outcome of results was assessed upon cases of Hydronephrosis diagnosed by USG findings. Careful history taking was done to determine any etiological factors. · Complete physical examination · Blood Investigations (CBC, RFT), LFT if required. · Urine Investigations (Urine R/M and C/S). · Radiological investigations including X-ray abdomen/KUB, IVP, Ultrasound KUB, RGU and MCU if needed. · Procedures performed on each admitted patient were noted. ERA’S JOURNAL OF MEDICAL RESEARCH A CLINICO- EPIDEMIOLOGICAL STUDY OF HYDRONEPHROSIS AT ERA’S LUCKNOW MEDICAL COLLEGE , LUCKNOW KEYWORD: Hydronephrosis, Renal lump, Renal swellings VOL.4 NO.2 Original Article ERA’S JOURNAL OF MEDICAL RESEARCH, VOL.4 NO.2 Page: 112 Dr. Pankaj Kumar Professor Department of Surgery Era's Lucknow Medical College & Hospital, Lucknow Email: pkumar6661@gmail.com Contact no: +91-9839181447 Address for correspondence Received on : 26-08-2017 Accepted on : 15-12-2017 DOI:10.24041/ejmr2017.44