A third of the world's population suffers from inflammatory processes in the kidneys. But not many people know that these problems, for the most part, are associated with pyeloectasis of the right kidney and only sometimes - with the left. With this anomaly, the renal pelvis expands. This happens due to the accumulation of fluid in it, which then travels through the ureters to the bladder.
- Causes and forms of the disease
- Symptoms and complications of pyeelectasis
- Establishing diagnosis
- Therapy (treatment) and prevention
What is pyelectasia?
Pyeloectasia is an expansion of the renal pelvis (pyelos (Greek) - pelvis; ectasia - expansion). In children, as a rule, pyeelectasis is congenital. If the calyxes are dilated along with the pelvis, then they speak of pyelocalicoectasia or hydronephrotic transformation of the kidneys. If the ureter is dilated along with the pelvis, this condition is called ureteropyeloectasia (ureter), megaureter or ureterohydronephrosis. Pyeelectasis is 3-5 times more common in boys than in girls. There is both unilateral and bilateral pathology. Mild forms of pyelectasis often go away on their own, while severe forms often require surgical treatment.
Classification of the syndrome
There are two forms of this condition depending on the degree of damage to the urinary organs:
- unilateral pyeelectasis of either the left or right kidney;
- bilateral pyelectasis of both kidneys. This condition requires immediate measures to solve this problem, since enlargement of the pelvis of both kidneys at once has a detrimental effect on the entire urinary system, and on the general condition and functionality of the body.
This syndrome is classified according to severity - mild, moderate or severe. It is important to take into account the volume of active preserved tissue and the presence of an inflammatory process, as well as pay attention to the presence of signs of renal failure.
If the syndrome progresses very quickly, the doctor diagnoses hydronephrosis, which has a unique set of symptoms that helps identify the presence of the disease. For example, these are nagging pain in the lower back, frequent urination and high blood pressure, which leads to fatigue, headaches, and a complete decrease in performance.
If the pelvis and calyx increase in size at the same time, this can lead to complete transformation of the kidney.
What can be an obstacle to the outflow of urine?
Often, an obstacle to the outflow of urine from the kidney is a narrowing of the ureter at the junction of the pelvis and the ureter, or when the ureter flows into the bladder. Narrowing of the ureter may be a consequence of its underdevelopment or compression from the outside by an additional formation (vessel, adhesions, tumor). Less commonly, the cause of impaired urine outflow from the pelvis is the formation of a valve in the area of the ureteropelvic junction (high ureteric outlet). Increased pressure in the bladder, resulting from a disruption of the nerve supply to the bladder (neurogenic bladder) or from the formation of a urethral valve, can also impede the flow of urine from the renal pelvis.
Types of disease
Highlight:
- Unilateral hydronephrosis
- Bilateral hydronephrosis
In the first case, the pyelocaliceal complex is affected only on one side, in the second - on both sides. Unilateral damage usually occurs against the background of congenital narrowing, conflict with abnormal renal vessels, as well as urolithiasis. The cause of a bilateral process can be stones, tumors or prostate adenoma.
The doctor knows how to treat kidney hydronephrosis at one stage or another. It is only important for the patient to contact a specialist as soon as possible.
What diagnostic methods are used for pyeelectasis in a newborn?
For mild pyelectasis, it may be sufficient to conduct regular ultrasound examinations (ultrasounds) every three months. If a urinary infection occurs or the degree of pyelectasia increases, a complete urological examination is indicated, including radiological research methods: cystography, excretory (intravenous) urography, radioisotope study of the kidneys. These methods allow you to establish a diagnosis - determine the level, degree and cause of the disturbance in the outflow of urine, as well as prescribe reasonable treatment. The research results themselves do not constitute a verdict that unambiguously determines the fate of the child. The decision to manage the patient is made by an experienced urologist, usually based on observation of the child, analysis of the causes and severity of the disease.
Establishing diagnosis
During a routine ultrasound examination of a pregnant woman, the doctor may detect pyeelectasis of the fetal kidney. Boys are more susceptible to this disease. In addition, statistics claim that the cause is most often dilation of the pelvis. In some cases, such diseases occur at a time when the child’s internal organs are growing too quickly. For the most part, pyeelectasis in children is congenital. This disease affects an adult as a result of a stone entering the ureter, which then becomes blocked. Accordingly, for any variant of the development and course of urolithiasis in the patient, an ultrasound examination of the affected organs is indicated.
Such an examination allows for accurate diagnosis and allows one to determine how static the size of the pelvis is before and after urination. At the same time, the progress of possible changes in organ size is monitored throughout the year. In certain cases, the doctor prescribes studies such as urography and cystography. They are necessary because the course of pyeloctasia changes greatly all the time. Accordingly, diagnostic methods need to be improved. In the case when pyeloectasia develops in both the right and left kidneys, the disease is severe, frequent relapses are inevitable, and even in the case when a complete cure occurs.
What diagnoses are made based on the examination?
Some examples of common diseases accompanied by pyelectasis:
- Hydronephrosis caused by an obstruction (obstruction) in the area of the ureteropelvic junction. It manifests itself as a sharp dilation of the pelvis without dilatation of the ureter.
- Vesicoureteral reflux is the backflow of urine from the bladder into the kidney. It manifests itself as significant changes in the size of the pelvis during ultrasound examinations and even during one examination.
- Megaureter - a sharp dilation of the ureter can accompany pyelectasis. Causes: severe vesicoureteral reflux, narrowing of the ureter in the lower section, high pressure in the bladder, etc.
- Posterior urethral valves in boys . Ultrasound reveals bilateral pyelectasis and dilatation of the ureters.
- Ectopic ureter - The flow of the ureter not into the bladder, but into the urethra in boys or the vagina in girls. Often occurs with double kidneys and is accompanied by pyeelectasis of the upper segment of the double kidney
- Ureterocele - the ureter, when it enters the bladder, is inflated in the form of a bubble, and its outlet is narrowed. Ultrasound reveals an additional cavity in the lumen of the bladder and often pyelectasis on the same side.
Prevention and treatment of pyelectasis
As a rule, in the case of congenital pyelectasis, surgical intervention is not possible. In this case, the narrowing of the ureter will be expanded using a stent - a frame that expands during installation and maintains the expanded position.
If pyeloectasia is formed as a result of urolithiasis, then treatment is aimed at eliminating the stones. Most often, doctors try to solve the problem without surgery; surgical methods are used in extreme cases.
It is worth noting that self-medication for pyeelectasis is very dangerous. The doctor prescribes treatment only after passing all the examinations and passing all the necessary tests.
Prevention of the anomaly includes timely identification of the problem, as well as complete treatment with impeccable compliance with all the doctor’s instructions, restriction in the use of liquids, and so on.
Pyeelectasia is an enlargement of the renal pelvis, which causes urine to accumulate in the pelvis before being discharged through the ureter. Pyeelectasia is not a disease, but a syndrome resulting from other kidney diseases. Timely detection of the problem and proper treatment can relieve pyeelectasis and protect against the development of complications. Be healthy!
Make an appointment with a urologist
If you have discovered one or more signs of hydronephrosis, contact our State Urology Center.
We invite you to make an appointment with a urologist at a convenient time. In our clinic you can undergo diagnosis and treatment of hydronephrosis free of charge as part of the compulsory medical insurance program. The sooner the disease is confirmed, the more effective the therapy will be. It is equally important to consult a doctor on time, as this reduces the risk of complications and generally improves the prognosis for recovery. October 19, 2020
Hakobyan Gagik Nersesovich - urologist, oncologist, MD, doctor of the highest category, professor
All the symptoms of the disease...
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- Experienced specialists.
Our doctors have all the skills and knowledge to treat renal hydronephrosis in adults and children. Specialists work in accordance with international standards and use organ-preserving techniques - Opportunities for comprehensive diagnostics.
Before starting treatment for kidney hydronephrosis in adults and children, an examination is carried out to assess the cause of symptoms, determine the degree of damage and other features of the course of the disease. We have modern expert-class equipment. It allows you to detect pathologies in the early stages - Individual therapy methods.
They are selected in accordance with the results of the patient’s examination, after analyzing laboratory and instrumental data - Gentle methods of surgical treatment.
The therapy uses the capabilities of endoscopy, microsurgery and laparoscopy. If possible, operations are performed through small punctures, including using robotic technologies - Modern hospital.
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To undergo treatment for renal hydronephrosis in adults and children in our clinics, call (495) 7-800-500. Our specialist will answer all questions and offer a convenient time for consultation with a doctor. You can also make an appointment through the SmartMed app.
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More details
Symptoms and complications of the disease
As a rule, pyeelectasis does not have any symptoms. They can manifest themselves in the presence of an underlying disease that led to the occurrence of pyelectasis, or in a disease that arose as a consequence of this pathology.
The following complications may occur with pyelectasis:
- Pyelonephritis, that is, inflammation of the kidneys.
- Tissue atrophy of the affected kidney.
- Kidney failure.
- Necrosis of urinary tissue.
Read which antibiotics to choose for ielonephritis.
Diagnosis of pyeelectasis of the right kidney
Since this disease occurs over a long period of time without the manifestation of any distinctive symptoms, it is extremely difficult to diagnose. But there are still methods to recognize this anomaly.
Most often, excretory urography is used for diagnosis. A special substance is injected into the human body, then its distribution through the urinary system is monitored using x-rays . As a result, it becomes possible to assess the capacity of the urinary canals, determine the presence of pyelectasis and its severity.
This method cannot be used during pregnancy, as X-ray radiation can cause serious harm to the health of the fetus. Accordingly, in this case, another diagnostic technique is used, this is ultrasound. During the study, the size of the renal pelvis is assessed before and after urination.
Main symptoms
Most patients complain of the following manifestations of hydronephrosis:
- severe pain in the lower back and abdomen, which can radiate to other parts of the body
- increase in body temperature
- weakness
- chills
- the appearance of blood clots in the urine
- headaches and increased blood pressure
- there may be a completely asymptomatic course when the pathology is present from birth and the body has adapted to it
The more advanced the disease, the more pronounced its symptoms become.
The more advanced the disease, the more pronounced its symptoms become.
Important! Body temperature rises when the disease is accompanied by an infection. In this case, it is very important to carry out immediate treatment.
Symptoms of hydronephrosis may also include bloating, constant nausea and severe vomiting, increased fatigue with decreased performance.
In children, signs of the disease include:
- cloudy urine
- reducing the amount of daily urine
- pain
Like adults, children complain of weakness, headaches, and nausea. Parents should pay close attention to the child’s health if he refuses his favorite food, games, walks, becomes lethargic and sleeps a lot.
Competent treatment of kidney hydronephrosis in an adult or child is impossible without a high-quality comprehensive examination.
