In ureteric injury when the injury is identified post operatively why the kidney will shrink?

in ureteric injury when the injury is identified post operatively why the kidney will shrink ? Shouldn’t it swell because ureter is injured and due to it there can be hydronephrosis.

When there is a ureteric injury, the subsequent effect on the kidney can vary depending on several factors, including the nature and extent of the injury, the timing of identification and intervention, and the individual’s overall health. Let’s break down the possible scenarios and their impact on the kidney’s size:

  1. Hydronephrosis:
  • Hydronephrosis is the swelling or enlargement of the kidney due to the accumulation of urine within the renal pelvis and calyces. It typically occurs when there is an obstruction in the ureter, such as a stone or a kink, preventing urine from flowing freely from the kidney to the bladder.
  • In the context of ureteric injury, if the injury causes a complete or partial blockage or obstruction of the ureter, it can lead to hydronephrosis and subsequent swelling of the affected kidney.
  1. Post-operative Ureteric Injury:
  • If a ureteric injury occurs during surgery and is identified post-operatively, it might not immediately cause hydronephrosis.
  • In the early stages, the injury may not completely obstruct the ureter, allowing some urine to still pass through and preventing immediate significant swelling of the kidney.
  1. Delayed Effects:
  • Over time, if the ureteric injury causes a stricture or significant obstruction, it can lead to hydronephrosis and enlargement of the kidney. The accumulation of urine above the site of injury can cause increased pressure and expansion of the renal pelvis and calyces.
  1. Atrophy and Kidney Shrinkage:
  • In cases where the ureteric injury is severe and the ureter is completely obstructed or damaged, it can lead to a loss of kidney function and subsequent atrophy (shrinkage) of the affected kidney.
  • If the kidney is unable to drain urine properly due to the ureteric injury, it can experience a decrease in size and function over time.

In summary, the kidney may initially not swell immediately after a ureteric injury, especially if the injury is partial or not causing a complete blockage. However, if the injury results in obstruction, over time, it can lead to hydronephrosis and eventual kidney swelling. In severe cases or with prolonged obstruction, the affected kidney may undergo atrophy and shrinkage due to loss of function. The specific outcome will depend on the severity and nature of the ureteric injury and the promptness and effectiveness of any necessary interventions.