Hydronephrosis - a disease in which the kidneys pathologically increase the cavity to collect urine( calyx and pelvis).This is due to the difficulty of outflow of urine and, as a consequence, the increase in hydrostatic pressure in them. At the same time, the blood vessels are squeezed, which means that the nutrition of the kidney tissues worsens. Gradually, this leads to their atrophy, which negatively affects the functions of the kidneys. Hydronephrosis of the right kidney and left - the phenomena of frequency are the same. But the disease is mainly one-sided.
- What causes the ailment
- Hydronephrosis in newborns
- Symptoms of
- Treatment of
- How hydronephrosis manifests in adults
- How the pathology is treated
- Surgical treatment
What causes the ailment
Unfortunately, we not only acquire this disease during life. Hydronephrosis can also be congenital. And there are several reasons for this:
- abnormal location of the renal arteries and their branches that squeeze the ureter;
- impairment of urinary tract motility( dyskinesia);
- abnormal narrowing of the urethra( congenital strictures);
- obstruction of the urinary tract;
- incorrectly located ureter.
In adults acquired hydronephrosis can contribute to such urological diseases:
- inflammation of the urino-genital organs;
- formation of calculi in the kidneys;
- cicatricial narrowing of the urinary tract;
- neoplasms of the urinary tract, cervix and uterus, ovaries and prostate;
- malignant tumors and their metastases;
- reflex violation of the outflow of urine in spinal cord injuries.
Hydronephrosis in newborns
This disease is very serious. Its signs are visible on ultrasound already on the 20th week of pregnancy. Usually observed hydronephrosis of the left kidney or right.
There are three degrees of the disease:
- I degree - the renal pelvis is stretched from the excess urine pressure, the size of the kidney itself also increases, but its function is not broken.
- II degree - a significant expansion of the pelvis and calyxes, the parenchyma of the kidney becomes thinner, the kidney function is impaired.
- III degree - renal tissue atrophy progresses, kidney functions are lost and it gradually dies, which is very dangerous for the child.
If a disease is found, treatment should begin without delay, because there is a real threat to the life of the child.
The disease in newborns can not appear immediately: the first and second degree can not give any symptoms. It is possible to suspect an abnormal condition due to a special anxiety of the baby or by the presence of blood in the urine. As we have already said, in most cases, hydronephrosis is detected even before the birth of the child. But it happens when the newly born babies or in the first year of their life have symptoms of the disease: abdominal pain and the presence of an unknown nature in it, as well as frequent infections of the urinary system.
When performing ultrasound, already from the 15th week of pregnancy, the collective kidney system of the child is clearly visible. Any expansion of her pelvis is considered the main sign of the disease. The pregnant woman is constantly observed, and after the delivery, a new sonogram is repeated. If there are again signs of hydronephrosis, additional urological examinations are prescribed. After all the diagnostic procedures and about a month after birth, the pediatric urologist will put an accurate diagnosis.
In newborns with the first and second degree of hydronephrosis of the kidneys, sometimes the symptoms of the disease disappear themselves, without treatment. In other cases, it is enough to conduct ultrasound( once a quarter), i.e.observation in dynamics. If the pelvis gradually expands, then most likely, surgery is required.
Conservative treatment can be used only to reduce the inflammatory process in secondary infection or to ease pain before surgery.
When the disease has passed to the third degree, treatment is required exceptionally prompt. If it is expressed and there are violations of urination, then immediately done surgery.
It is called pyeloplasty of the kidneys, the percentage of its effectiveness is high enough( up to 95%).Almost always, kidney functions are restored, but some structural changes in the calyx and in the kidney parenchyma can remain.
How hydronephrosis manifests in adults
Often the disease develops without symptoms, and generally has no specific manifestations. However, its most constant symptom is a dull aching pain in the lower back, which does not vary from the position of the body and from the time of day.
Hydronephrosis of the right kidney may be similar to cholecystitis or liver disease, since pain is localized in the right side of the abdomen. During bouts of pain, blood pressure may rise, nausea and vomiting, bloating may appear. When the infection joins, the body temperature can rise.
But in other cases, the presence of blood in the urine is the only symptom. This is typical for the situation when the cause of the pathology was urolithiasis. Stones, passing through the ureters, injure them.
The third stage of hydronephrosis is characterized by renal failure with a decrease in the amount of urine and edema. Anemia develops and blood pressure rises.
Diagnosis of the disease with external examination, laboratory methods( urine and blood analysis) and instrumental studies( renal ultrasound, radioisotope urography, MRI and computed tomography).
How the pathology of
is treated If the examination has confirmed the diagnosis of hydronephrosis, the treatment is carried out taking into account its cause, degree and rate of dynamics. Without surgery, it is impossible to restore health to the patient. But before the operation, symptomatic treatment is applied: analgesia, inflammation removal, pressure reduction. When the infection is carried out antibacterial therapy.
Surgical treatment of
The patient needs to be operated in the early stages of the disease, while changes in the kidneys are still reversible. In the overwhelming majority of operations, the kidney is preserved. Its goal is to eliminate the cause of hydronephrosis and restore the normal functioning of the kidney. In the early period of the disease, the patency of the urinary tract is restored, in the last stage the pelvis is plasticized. When the kidney is completely destroyed, its nephrectomy( removal) is performed.
Conclusion: if the described signs have appeared, you can not delay with treatment. The disease is very serious, and only an early operation can give a full recovery.