The main reasons for the expansion of the renal pelvis. The renal pelvis system is expanding - what is this problem and how can it be dealt with? Enlarged renal pelvis

March 25, 2017 Doctor

There are norms for the size of the kidney cavity depending on a person’s age, and deviation from them indicates the development of the disease. One of these pathologies is the expansion of the renal pelvis in adults, which has medical term"pyelectasia". It is not considered as an independent disease, because refers to indirect symptoms of dysfunction of the urinary organs excretory system. To cure it, it is necessary to eliminate the cause of its development, otherwise the condition of the organ will only worsen.

Volume increase renal pelvis usually indicates the presence of infection, but it may also be due to the structural features of the organ. The pathology occurs due to a violation of the outflow of urine - it stagnates in the kidneys, which is why their volume gradually increases. Pyeelectasis has 3 degrees of development: mild, moderate and severe. On initial stage the disease there is a slight expansion of the pelvis, which is accompanied by barely noticeable manifestations. As the disease develops and worsens, pathological changes also affect the calyces and ureter.

Pyeelectasis can have unilateral or bilateral manifestations. Most often, only one kidney is affected, and the right one, which is explained by the peculiarity of the anatomical location of the organs. Men are most susceptible to the disease, but in women it is much less common. With bilateral kidney damage, the patient’s health condition sharply worsens, while with unilateral pathology, the healthy organ fully compensates for the work of the damaged one, so it is impossible to suspect the presence of the disease in the first stages.

Forms

Depending on the causes, enlargement of the renal pelvis in adults is divided into acquired and congenital forms, which in turn can be organic and dynamic:

Organic purchased. Usually occurs against the background of inflammatory diseases, or due to narrowing of the ureter, which can result from injury. It is also not uncommon that the causes of pathology lie in kidney prolapse, the presence of tumors or stones in their cavity.
Organic innate. It is diagnosed in a child before birth, or in the first few days after. The only reason why the renal pelvis is enlarged is an anomaly in the development of organs urinary system.
Dynamic acquired. Observed in adult patients with a tumor of the urethra or prostate, infectious or inflammatory diseases. In addition, this form of pyelectasis can be caused by hormonal disorder and narrowing of the urethra.
Dynamic congenital. The underlying factors may be narrowing, tightness or phimosis of the urethra, as well as neurogenic urination disorder.

Symptoms and associated diseases

Pyeelectasia begins to appear only after infection has occurred, and the main symptoms will be pain in the lower back, fever, dizziness, and others. characteristic features. Often, enlargement of the calyces and renal pelvis is diagnosed in the later stages, when the patient consults a doctor complaining of constant pain, but there are also cases of pathology being detected during a routine medical examination.

Some diseases may indicate the development of pyelectasis, including:

Ectopic ureter. An anomaly in which the ureter in men flows into the urethra, and in women into the vagina. Pathological changes occur in the upper part of the kidney.
Ureterocele. The disease is a swelling of the ureter in the part where it flows into bladder, but at the same time the outlet retains its dimensions or narrows slightly. When examining a patient using an ultrasound machine, you will notice that the renal pelvis is dilated.
Megaureter. With this pathology, the size of the ureter sharply increases, which occurs due to a narrowing of its lower sections. As a result, pressure in the bladder increases, which affects all organs of the urinary system.
Vesicoureteral reflux. The disease is characterized by the reverse flow of urine from the ureter into the kidney cavity.
Damage to the valves of the posterior part of the urethra, which is typical mainly for the male part of the population. The pathology is accompanied by bilateral pyelectasis and an increase in the volume of the ureter.

Due to decreased kidney function, a number of complications can occur, including renal sclerosis, tissue atrophy, failure and inflammatory processes.

Diagnosis and treatment

The main method of detecting the disease is ultrasound. In the presence of pathology, not only small enlargements of the cavity can be observed, but also doubled sizes of the renal pelvis - the norm in adults in a healthy state should not exceed 10 mm. Because the this phenomenon refers to the symptoms of one of the diseases of the urinary system, it is necessary to find its cause, and for this a number of diagnostic measures are used:

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After confirming the diagnosis, it is prescribed complex treatment, which will help eliminate the root cause of the disease, improve the functions of the urinary system, and generally strengthen the body. In most cases, pyeelectasis can be treated with medication, and only occasionally do doctors have to use surgical methods. For example, such a need arises when urolithiasis when large stones are observed that affect the size of the pelvis or block the ureter.

In children congenital form usually does not require treatment, but their health condition must be constantly monitored by a doctor. If disturbances in the functioning of the urinary function are detected, or the size of the pelvis begins to rapidly increase, drug therapy will be prescribed.

Due to hormonal changes, the pelvis can be dilated during pregnancy, and its volume constantly increases throughout the entire period of gestation. It should be noted that the disease can also occur against the background of urolithiasis and infectious diseases. In order not to harm the baby, they prescribe conservative treatment, and only in extreme cases is it recommended to perform surgery.

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In modern medical practice, diseases are common genitourinary system. Among them, a common pathology is an enlarged renal pelvis, which is accompanied by difficult outflow of urine. The pelvis is the place where urine from the kidneys is collected and flows into the ureters. Children and adults are susceptible to the disease. More often, the renal pelvis is dilated in a male child.

The disease can be unilateral or bilateral, when one or both pelvis is affected. According to the degree of difficulty, they are divided into light, medium and severe forms.

The causes of dilatation can be dynamic congenital, when the disease develops as a result of stenosis of the external opening of the urethra, severe phimosis, organic narrowing of the urethra, neurogenic dysfunctions Bladder.

With dynamic acquired dilated renal pelvis is formed due to hormonal changes, inflammatory pathologies of the kidneys, infectious processes, tumors of the urethra or prostate, narrowing of the urethra of an inflammatory or traumatic nature, benign prostate adenoma.

Organic congenital include anomalies of the ureter, kidneys, walls of the upper urinary tract.

Organic acquired ones occur with inflammation of the ureter and tissues surrounding it, tumors of the genitourinary system, nephroptosis (prolapse) of the kidney, urolithiasis.

Most often, the dilated renal pelvis is asymptomatic. Signs of the underlying pathology that caused the development of the disease bring concern. Infectious and inflammatory processes that develop during prolonged stagnation of urine in the pelvis also make themselves felt.

In most cases, pathology is detected during pregnancy or during the first year of a child’s life. Some experts attribute this disease To congenital features buildings. Often, an enlarged renal pelvis in a child occurs during intensive growth, since at this time the location of the organs changes relative to each other. At an older age, expansion occurs when the lumen of the ureters is blocked by a stone.

First of all, we should be concerned following points. When performing an ultrasound examination (ultrasound), a change in the volume of the pelvis occurs before and after the process of urination. If the size of the organ is 7 mm or more, and the change occurs within a year.

An enlarged renal pelvis can lead to complications: decreased kidney function, inflammation (pyelonephritis), atrophy of the kidney tissue (reduction in size), kidney sclerosis, a condition accompanied by the death of urinary-producing kidney tissue.

Enlarged renal pelvis: diagnosis and treatment

For pelvis sizes up to seven mm, control studies of the kidneys and bladder are performed, which are performed every 1-3 months. Ultrasounds for children after one year of age are prescribed once every six months. As the disease progresses, urography and cystography are performed, X-ray research methods using a contrast agent, which is injected through a catheter into the bladder.

During urography, a contrast agent is administered intravenously. Using research data, it is established the real reason development of expansion of the pelvis.
Treatment of an enlarged renal pelvis is primarily aimed at eliminating the cause that led to the disruption of urine outflow. Congenital abnormalities are corrected through surgery. Stenting is used, which involves inserting special frames into the narrowed areas. For enlargements resulting from urolithiasis, a method for removing stones is selected, which may consist of conservative or surgical treatment. A variety of physiotherapeutic procedures are often used. In some cases, herbal treatment is prescribed.
Particular attention is paid to preventing the development of inflammatory processes. Surgical interventions are performed endoscopically using miniature instruments.

In the human kidneys there are so-called pelvises. They are special containers that hold urine before it passes into the ureter. In a normal healthy state, the size of the pelvis can vary depending on human parameters: height, weight, general physique. However, if the doctor discovers that the patient’s renal pelvis is dilated and it has been in this state relatively recently, then he diagnoses pyelectasis. More advanced stages represent serious deviations and pathologies.

It should be noted that the pelvis is part of a single pyelocaliceal system, which is responsible for the accumulation and subsequent transportation of urine. The fact is that the calyx and pelvis are connected by a very narrow passage called the neck. By its nature, it is very small in diameter, so the slightest blockage can lead to expansion of the renal pelvis.

Basic prerequisites for pelvis enlargement

Most often, this disease occurs as a congenital disease, but it can also be acquired during life. In general, an enlargement of the renal pelvis is a sign of improper outflow of urine, which, in turn, is the root cause of the deviation. But it is worth considering specific factors that contribute to the development of the disease:

kidney stones;
bladder fullness;
formation of tumors in the organs of the excretory system;
narrowing of the urinary tract due to injury;
disturbances of normal urinary outflow, in particular, its weakening due to an enlarged pelvis;
inflammatory processes occurring in the urinary system;
increase in intrarenal pressure.

Genetics also plays an important role. If there were or are people in your family suffering from kidney diseases, then there is a high probability that it will work hereditary factor. Therefore, it is always important to protect the health of your loved ones, and if necessary, send them for examination.

If you do not want your children - the future generation - to be susceptible to urolithiasis, then start taking care of yourself first, consult a doctor and do not delay treatment.

And all of the above reasons are associated primarily with other diseases of the human excretory system. In addition, some patients have anatomical abnormalities, resulting in abnormal organ structure. They also cause dilation of the pelvis, so it is recommended to undergo a hospital examination on a regular basis at least once a year.

Kidney diseases are the root cause of dilated pelvis

Symptoms and diagnosis of pyelectasis

It is quite difficult to identify kidney diseases on your own, for this reason they may remain for a long time unnoticed. To understand that the pelvis is enlarged, you need to know the corresponding signs that the patient can observe. It is worth noting that the course of the disease and the characteristics of the dilated pelvis in children, in general, are somewhat different from what adults observe. Therefore, here we will look at the main signs and symptoms that occur when the renal pelvis enlarges in an adult (but remember that pyeelectasis is not the main disease, but occurs as a complication):

Pain in the lumbar area. Although they can be caused by other abnormalities, it is important to consider their severity.
Poor urine flow is unpleasant urination associated with urine retention, but at the same time you often want to go to the toilet.
The occurrence or presence of all kinds of infections, and they can also manifest themselves in their own way.

Such a small number of signs that the renal pelvis is enlarged suggests that this phenomenon is practically asymptomatic. However, everyone should have basic ideas and knowledge. Now the only question is the correct diagnosis.

Urography is necessary and useful method studies of the excretory system organs

The most accurate result is provided by ultrasound examination. And usually, dilation of the renal pelvis is an extremely unexpected diagnosis for the patient. Therefore, after an ultrasound, the doctor prescribes further examination to help determine the overall condition of the human body. This may include:

General urine analysis. It is necessary to identify all possible concomitant diseases and infections.
Cystography. Shows the condition of the bladder: a bright substance is injected into it, after which an x-ray is taken
Urography. In this method, a dye is also injected, which passes through the kidneys and is then excreted through the excretory organs.

All this helps to most accurately determine the state of the human excretory system and, therefore, prescribe the appropriate course of treatment.

Prevention measures

To avoid such a disease as an enlarged renal pelvis, you should follow some recommendations. To begin with, remember that under no circumstances should you endure or put off going to the toilet for a long time. This can have a negative impact on your entire urinary system.

To prevent further development enlargement of the pelvis, it is important to maintain normal blood circulation and stimulate the outflow of urine

After several hours of sedentary work, it is simply necessary to do at least a small warm-up. Firstly, it will improve blood circulation, and secondly, it will prevent stagnation of urine and normalize its outflow. In general, especially people in adulthood whose renal pelvis is dilated, need to exercise more often, since many lead a completely inactive lifestyle.

In addition, you can strengthen your immunity with various vitamins, and some prefer folk medicine. This is not bad if the use of tinctures and decoctions does not go beyond the normal, and they, in turn, consist of truly useful components.

Remember! Under no circumstances should you self-medicate, as it will do more harm than good. Take vitamins and eat right, but do not overdo it with folk remedies.

Treatment methods for enlarged pelvis

Initially, doctors are struggling with the reasons for the expansion of the collecting system, since it is at this stage that the disease can be most safely eradicated, as well as possible complications and pathologies can be prevented. Based on the results of the examinations and from his professional point of view, the doctor decides whether it is applicable in in this case conservative treatment, and whether the patient needs surgery.

Almost every patient has to start by taking medications, which are able to stop the inflammatory processes occurring in the CLS. In addition, patients are forced to follow a simple diet. It is important to drink less liquids, but not to reach an extreme state, otherwise the body will simply become dehydrated. It is also necessary to give up diuretics, which, by the way, includes coffee.

Current surgical intervention provides painless treatment patients

Next, the doctor looks at the stability of the person’s condition, and again a picture of the renal pelvis is taken. He can prescribe a course of drugs sold strictly according to the prescription, or announce to his patient about the upcoming operation. But there is no need to be afraid of this, since modern technologies make it possible not to perform open operations, interfering with the dilated pelvis of the kidney in an adult only through urethra.

This operation allows you to improve the flow of urine by correcting the position of the cervix. After successful completion of the procedure, the patient can be prescribed medications aimed at restoring the body and immunity as a whole.

Special cases of the disease

The consequences of kidney disease during pregnancy should be considered, since this topic is especially exciting for expectant mothers. Moreover, they cause discomfort, which creates an additional reason for stress for a woman. There are two types of occurrence of this disease:

During such a period, the expectant mother simply needs the care of loved ones. Especially considering the fact that the physiological and mental health are closely interconnected. Timely visit to the hospital can prevent the worst consequences, so never delay going to the doctor. Firstly, his consultation will help you monitor your health, and secondly, you will protect not only yourself, but also your loved ones, in particular, children.

The renal pelvis is a special cavity in which urine from the kidneys accumulates. Urine enters the renal pelvis from the renal calyces, and from the pelvis is transported to the ureters and then to the bladder. If the renal pelvis is enlarged in adults, then treatment depends on the diagnosis and form of the pathology.

A disease such as dilatation of the renal pelvis occurs when the outflow of urine into the ureter from the renal pelvis is impaired. The passage of urine is impaired due to blockage of the ureter, narrowing of its lumen.

In children, the disease occurs due to congenital abnormalities in the formation of the urinary system. The immediate causes include narrowing of the lumen of the ureter, its bending due to improper placement of the kidney.

Also, the reasons for the enlargement of the renal pelvis include an increase in urine pressure due to the formation of an obstacle to its discharge, narrowing of the urinary channels, and reverse release of urine into the kidneys. To identify pathology in the fetus, an ultrasound examination is organized at 16 - 20 weeks of its development.

Pyeelectasis is considered a problem, since with its development, stagnation forms in the urinary organs and the process of atrophy of the kidney tissue begins, and the functioning of the kidneys deteriorates. As a result of these deviations, sclerosis of the kidney occurs.

In an adult, pyeloetasias most often develops after suffering from urolithiasis. In this case, the stone can be located in the pelvic cavity or even in the ureter itself. Enlargement of the renal pelvis in adults can develop due to the influence of neoplastic tumors, when the tumor puts strong pressure on the ureter and causes a disruption in the passage of urine.

Diagnosis and manifestation of pathology

In most situations, enlargement of the renal pelvis itself is not characterized by special symptoms, but clinical picture represents manifestations of the underlying pathology that provoked pyelectasis.

In addition, stagnation of urine in the pelvis contributes to the formation of an infectious and inflammatory process. Often the disease is detected completely accidentally during an ultrasound examination.

The expansion of the renal pelvis in adults is caused by blockage of the ureter with a stone, and therefore, with the development of urolithiasis and other provoking factors, it is imperative to conduct an ultrasound examination of the kidney in order to prevent serious complications.

When organizing an ultrasound examination, doctors pay attention to the size of the renal pelvis in adults before and after urination, as well as to changes in size during Last year. Due to the frequent progression of pathology, additional diagnostic methods are used to determine the cause of the lesion, such as urography - intravenous administration contrast agent, cystography - the introduction of a contrast agent into the bladder using a catheter.

Treatment of pathology

In order to eliminate the expansion of the renal pelvis in adults, it is necessary to initially combat the cause that led to this lesion, which provoked a violation of urine output.

Congenital etiological factors of pathology can be successfully corrected through surgical intervention. When the ureter is narrowed, a stenting method can be used - when a special “frame” is inserted into the narrowed area.

In 70% of cases, congenital pyeloectasia resolves spontaneously due to the maturation of the child’s urinary system in the first year after birth. In 25% of cases of the disease it is necessary to carry out conservative therapy, which represents the reception medications prescribed by a nephrologist. And only in 5% of cases of pathology in children may surgical intervention be required using an endoscopic technique, that is, without open surgery of the urinary canal.

If the normal size of the renal pelvis in adults has increased due to urolithiasis, then the doctor decides on the most appropriate method of removing stones. In this situation, both conservative and surgical methods can also be implemented.

Before the causes of the disease are eliminated, treatment of an enlarged renal pelvis consists of preventing the formation of inflammatory processes. For this purpose, experts recommend using medicines, which could help destroy pathogenic microorganisms that enter the urine. In addition, you should avoid excessive fluid intake, as well as diuretic products or medications.

Surgery for an adult affected by pyeloetasis is required in 25 - 40% of cases. Currently there is no way to help predict the course of the disease, so the question of surgery The doctor decides only after carefully monitoring the patient and conducting an examination. In case of pronounced pyelectasis or active development of dilation in the pelvis and deterioration of kidney function, surgical intervention may be necessary.

The operation makes it possible to eliminate the existing obstruction to the outflow of urine or get rid of vesicoureteral reflux. Many surgical interventions are successfully performed through endoscopy, that is, without open operations, but with the help of small instruments that reach the site of the lesion through the urinary canal.

Danger of developing pathology

This disease is considered a manifestation of abnormalities in the functioning of the urinary system. Difficulty in passing urine may increase, causing compression, atrophy in the renal tissue and deterioration of the kidney. In addition, improper outflow of urine is often accompanied by pyelonephritis, an inflammatory process in the kidney that impairs its function and can lead to kidney sclerosis.

It is important to remember that enlargement of the renal pelvis is not an independent disease - it is just an indirect symptom of the appearance of a disorder due to negative influence on the passage of urine from the pelvis. Based on the above, it becomes clear that the main treatment of pathology depends on the specific causes of its development.

Date: 11-02-2015
Rating: 27

Diagnosis and treatment of pyelectasis

The renal pelvis is a container that collects urine and then passes it into the ureters and bladder. If there are pathological obstacles to the movement of urine, it accumulates, which can cause the renal pelvis to become enlarged. This disease is called pyelectasis. It can be diagnosed not only in an adult, but also in a child.

Causes and classification of pyelectasis

An enlarged pelvis occurs due to a violation of the outflow of urine into the ureter. In a child, the pathology may be caused by congenital abnormalities of the urinary system. Direct causes include kinking of the ureter due to abnormal placement of the kidney or a decrease in its lumen. To detect pyelectasis of the left or right kidney An ultrasound scan is performed in the fetus at 15-19 weeks of development.

In an adult, an enlarged pelvis usually occurs due to urolithiasis, when a stone enters the pelvic region or ureter. Also, pyeloectasia can be a consequence of a tumor formation, when it puts pressure on the ureter, blocking it.

Depending on the extent of the lesion, unilateral or bilateral pyelectasis is distinguished. However left kidney less likely to be exposed this disease than the right one, which is due to the peculiarities of its structure. Enlargement of the renal pelvis is also classified according to the severity of the disease. According to this principle, the disease can occur in mild, moderate and severe forms. The severity of the pathology is determined by the ability of the kidneys to perform their functions.

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Symptoms and complications of an enlarged renal pelvis

Typically, pyeloectasia in children and adults is completely asymptomatic. The patient can only be disturbed by the symptoms of the underlying disease, which leads to dilation of the renal pelvis. Stagnation of urine that occurs during illness sometimes causes tissue atrophy, the development of sclerosis and renal failure, which in the absence of qualified treatment can lead to death.

Enlargement of the renal pelvis may be accompanied by the following diseases:

ectopia, in which in boys the ureter flows into the urethra, and in girls into the vagina;
megaureter (significant increase in the size of the urinary duct);
Vesicoureteral reflux is a process in which urine from the bladder flows back into the kidney.

Due to the occurrence of inflammatory processes, a patient whose renal pelvis is dilated may also suffer from pyelonephritis and cystitis.

Basic prerequisites for pelvis enlargement

kidney stones;
bladder fullness;
formation of tumors in the organs of the excretory system;
narrowing of the urinary tract due to injury;
disturbances of normal urinary outflow, in particular, its weakening due to an enlarged pelvis;
inflammatory processes occurring in the urinary system;
increase in intrarenal pressure.

Genetics also plays an important role. If there were or are people in your family suffering from kidney diseases, then there is a high probability that a hereditary factor will work. Therefore, it is always important to protect the health of your loved ones, and if necessary, send them for examination.

If you do not want your children - the future generation - to be susceptible to urolithiasis, then start taking care of yourself first, consult a doctor and do not delay treatment.

Kidney diseases are the root cause of dilated pelvis

Symptoms and diagnosis of pyelectasis

It is quite difficult to identify kidney diseases on your own, for this reason they can go undetected for a long time. To understand that the pelvis is enlarged, you need to know the corresponding signs that the patient can observe. It is worth noting that the course of the disease and the characteristics of the dilated pelvis in children, in general, are somewhat different from what adults observe. Therefore, here we will look at the main signs and symptoms that occur when the renal pelvis enlarges in an adult (but remember that pyeelectasis is not the main disease, but occurs as a complication):

Pain in the lumbar area. Although they can be caused by other abnormalities, it is important to consider their severity.
Poor urine flow is unpleasant urination associated with urine retention, but at the same time you often want to go to the toilet.
The occurrence or presence of all kinds of infections, and they can also manifest themselves in their own way.

Urography is a necessary and useful method for examining the organs of the excretory system.

General urine analysis. It is necessary to identify all possible concomitant diseases and infections.
Cystography. Shows the condition of the bladder: a bright substance is injected into it, after which an x-ray is taken
Urography. In this method, a dye is also injected, which passes through the kidneys and is then excreted through the excretory organs.

All this helps to most accurately determine the state of the human excretory system and, therefore, prescribe the appropriate course of treatment.

Prevention measures

To prevent further development of an enlarged pelvis, it is important to maintain normal blood circulation and stimulate the flow of urine

In addition, you can strengthen your immunity with various vitamins, and some prefer traditional medicine. This is not bad if the use of tinctures and decoctions does not go beyond the normal, and they, in turn, consist of truly useful components.

Remember! Under no circumstances should you self-medicate, as it will do more harm than good. Take vitamins and eat right, but do not overdo it with folk remedies.

Treatment methods for enlarged pelvis

Initially, doctors are struggling with the reasons for the expansion of the collecting system, since it is at this stage that the disease can be most safely eradicated, as well as possible complications and pathologies can be prevented. Based on the results of the examinations and from his professional point of view, the doctor decides whether conservative treatment is applicable in this case, and whether the patient needs surgical intervention.

Almost every patient has to start by taking medications that can stop the inflammatory processes occurring in the CLS. In addition, patients are forced to follow a simple diet. It is important to drink less liquids, but not to reach an extreme state, otherwise the body will simply become dehydrated. It is also necessary to give up diuretics, which, by the way, includes coffee.

Current surgical intervention provides painless treatment for patients

Next, the doctor looks at the stability of the person’s condition, and again a picture of the renal pelvis is taken. He can prescribe a course of drugs sold strictly according to the prescription, or announce to his patient about the upcoming operation. But there is no need to be afraid of this, since modern technologies make it possible not to perform open operations, intervening in the dilated pelvis of the kidney in an adult only through the urethra.

Special cases of the disease

During such a period, the expectant mother simply needs the care of loved ones. Especially considering the fact that physiological and mental health are closely interconnected. Timely visit to the hospital can prevent the worst consequences, so never delay going to the doctor. Firstly, his consultation will help you monitor your health, and secondly, you will protect not only yourself, but also your loved ones, in particular, children.

Pyeelectasia is a pathology that is practically asymptomatic in the first stages. If complaints or negative signs appear, after an in-depth examination, parents learn that the child has an enlarged renal pelvis.

How dangerous is the disease? Why does it occur congenital pathology? How to treat pyeloectasia in children? The answers are in the article.

What is the renal pelvis

Reasons for expansion

Signs and symptoms

Diagnostics

Conservative therapy

Surgical intervention

Possible complications

Prevention of complications

What is the renal pelvis

This important section is like a funnel. The pelvis is formed by large and small cups. Urine accumulates in the cavity before passing further along the ureter. The pelvis and renal cups are connected by a fairly narrow passage.

When the urinary tract is blocked, a pathology such as dilation of the pelvis often develops. Against the background of a negative process, the volume of the important pyelocaliceal system increases, doctors diagnose hydronephrosis.

Is pyeelectasis dangerous? With constant monitoring and maintenance therapy to preserve kidney function, the disease does not have serious consequences for child's body. The danger is different: complications due to an enlarged renal pelvis often provoke the development of intractable diseases.

In the absence of competent, timely treatment, it develops renal failure, vesicoureteral reflux, necrosis of ureteral tissue, impaired urine outflow. In advanced cases, nephrons die, virtually no urine is excreted, and life is threatened. For this reason, at the slightest suspicion of kidney problems, it is important to visit a pediatric urologist or nephrologist with your child.

Reasons for expansion

In most cases, congenital pathology develops against the background genetic predisposition. If family members have encountered a similar disease, when registering for pregnancy, the woman must notify the gynecologist about the problem. It is important to monitor fetal development for timely detection of abnormalities in the functioning of the urinary system.

What is kidney nephroptosis and how to treat the disease? Read useful information.

You can learn about the structure and functions of the kidneys in the human body from this article.

Enlargement of the renal pelvis also occurs for other reasons:

inflammatory process, bacterial infection;
prolapse of the left and right kidneys;
infrequent urination throughout the day, which provokes an inflammatory process;
congenital anomalies of the structure of important parts - the ureters;
accumulation of harmful salts, formation of stones;
pathologies of the structure of bean-shaped organs;
increased pressure in the ducts and kidneys.

Signs and symptoms

As long as the pathology does not provoke complications, the child in most cases does not feel negative manifestations. Older children can explain to their parents what is troubling them; in infants, it is more difficult to determine kidney problems: a comprehensive examination is needed in order to recognize the dilation of the renal pelvis in time.

Main signs of the disease:

problems with urination, including enuresis - urinary incontinence;
tearfulness, irritation;
painful sensations when emptying the bladder;
development of intoxication, lethargy, weakness;
decreased appetite;
decrease in physical activity;
the child sleeps longer than usual;
in thin children, a bulge is noticeable on the affected side;
bother discomfort in the lumbar region;
temperature increase.

Based on the results of a urine test, the doctor identifies abnormalities:

the level of leukocytes increases;
oxalates appear in urine;
one of the signs is blood in the urine;
the appearance of cylinders and specific cells.

Diagnostics

To confirm violations of the tissue structure in the kidneys, the urologist/nephrologist talks with the parents, the child (at the appropriate age), and prescribes urine and blood tests. To clarify the picture of pathology, highly informative studies using modern equipment are required.

The doctor prescribes:

contrast radiography to assess the quality of urine output;
examination of the retroperitoneal space and abdomen using ultrasound (ultrasound of the kidneys and bladder);
urine collection according to Zimnitsky, urine examination according to Nechiporenko.

Effective methods and rules of treatment

If the diagnosis of “enlargement of the renal pelvis” is confirmed, therapy depends on the age of the child. If the pathology is discovered during intrauterine development, then the woman should be in the hospital so that doctors regularly monitor the condition of the fetus.

After the birth of the child, doctors continue monitoring for up to three years. During this period, all organs are fully formed, the picture of the disease is clear. If complications or congenital kidney defects develop, surgery is required.

Conservative therapy

Drug therapy is effective for inflammatory processes in the bladder, kidneys, ureters.

For enlarged renal pelvis in children, the following is prescribed:

antibacterial compounds with active antimicrobial action;
herbal remedies for dissolving stones, removing sand and calculi from the body naturally;
myotropic drugs to reduce spasms of smooth muscles and normalize organ function.

Important! It is prohibited to independently select medications for the treatment of urinary tract pathologies in children of any age. Do not use stone removal compounds when large size salt formations. If conservative therapy is low in effectiveness, the urologist gives a referral for surgery.

Surgical intervention

If complications develop, bilateral pyelectasis cannot be avoided without surgical intervention. Inattention to the symptoms of the disease can cost a child’s life due to the death of nephrons, severe renal failure, acute intoxication body.

You should not refuse surgery if the doctor says that this is the only way to restore the child’s health and restore kidney function. Toxins that accumulate in the body due to improper functioning of the urinary tract and kidneys destroy the growing body from the inside.

Features of surgical treatment:

an operation is performed using endoscopic equipment;
to reduce the risk of infection in abdominal cavity a small puncture is made, an instrument with a camera and a miniature lamp is inserted, structural abnormalities in the renal pelvis are eliminated;
Even with sterility, there is always a risk of infection. For this reason, the child receives antibacterial drugs, is in a hospital under the supervision of doctors;
after recovery, every month parents must show the child to a urologist for six months;
The doctor gives recommendations and explains how to prevent kidney disease.

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About the causes of renal colic in women and treatment pain find out from this article.

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Possible complications

Parents should know the consequences of lack of timely treatment for pyeelectasis in young patients. It is important to listen to the complaints of a preschooler or teenager, pay attention to changes in the baby’s behavior, and conduct an examination.

Abnormal sizes of the renal pelvis often accelerate the development of dangerous changes:

noticeable narrowing of the opening of the ureter to remove processed fluid;
development of hydronephrosis;
inflammatory processes against the background of stagnation of urine. The spread of pathogenic microbes throughout organs and systems in advanced cases provokes death;
ectopia of the ureter. Negative changes cause nephron death and kidney failure;
Vesicoureteral reflux. Dangerous condition, in which urine is excreted not into the bladder, but into the kidneys, problems with work appear important organs, urine output is disrupted, and intoxication increases.

Prevention of complications

When pyelectasis is detected in childhood It is important to monitor the condition of your kidneys, undergo regular examinations, and take tests. Objectives: prevent intoxication and complications, reduce the risk of developing inflammatory processes, normalize the outflow of urine.

Mandatory elements of prevention:

proper nutrition, vitamin therapy;
eliminating high food load on the kidneys, avoiding irritating foods. Should not be given to children fried fish and meat, spicy, salty dishes, smoked meats, sweet soda, strong coffee, chocolate;
The child must drink a certain amount per day clean water: for each age, the urologist suggests the norm;
Do not lift heavy objects, play games or sports competitions, during which falls, bruises, accidental blows to the lumbar region, and injuries are possible;
It is important to avoid drafts, dress babies and older children according to the weather, and make sure that their shoes do not get wet.

Enlargement of the renal pelvis can lead to serious health consequences. If drug treatment is ineffective, parents should not hesitate if the doctor insists on surgical intervention. If problems with the renal pelvis are detected in the fetus, the woman should be monitored throughout her pregnancy to exclude complications that cause kidney malformations.

The renal pelvis can be dilated in a baby both at birth (congenital) and appear later (acquired). What are the reasons for the dilation of the renal pelvis in a child? How to treat the disease? Find out the answers to all your questions after watching the following video:

All about the kidneys > Types of diseases > Signs and diagnosis of enlarged renal pelvis

A huge number of people suffer from diseases of the genitourinary system. Often a person feels pain in the lumbar region, but chalks it up to fatigue, overwork, or an uncomfortable sleeping position.

But this may be the first sign that your kidneys are damaged. One of frequent illnesses in this area there is pyeloectasia, or dilatation of the renal pelvis.

But what is it, why is it dangerous and how to treat it? These are the first questions that swirl in the head of a patient who first heard his diagnosis from his attending physician.

In order to understand this disease, it is necessary to turn to the anatomy of the kidneys.

A healthy person has 2 kidneys, about the size of a fist and shaped like beans. They are located on both sides of the spine and perform very important functions– one of which is the formation and removal of urine (urine) from the body. The renal pelvis is involved in this process; it collects urine and then sends it through the ureter to the bladder.

If the renal pelvis enlarges, then urine does not pass out or flows very poorly into the ureter, which means urinary retention occurs, which is good.

This disease mainly affects boys and males, but the weaker sex suffers from this disease 6-7 times less often.

This disease rarely occurs independently; most often this pathology accompanies infections or structural anomalies.

As a result of the development of fetal anomalies, the child's renal pelvis may be enlarged. This is discovered for the first time years of life, using ultrasound. Most often, such children are born when the pregnant mother experiences severe stress, eats poorly and has bad habits.

But don’t be scared if your child has been diagnosed with this. It is not at all necessary to go under the surgeon’s knife, because mild forms go away on their own, or with the help of conservative treatment.

Causes of enlarged renal pelvis

Narrowing of the urinary tract.
Increased pressure in the bladder.
Genetic predisposition.
Vesicoureteral reflux, i.e. reverse flow of urine from the bladder.

Weakness of the muscular system in newborns (most often found in premature babies).
Constant overflow of the bladder, which is why you can’t stand it when you want to go to the toilet.
Urolithiasis disease.
Inflammatory kidney diseases, such as pyelonephritis.
Renal colic.
Large intake of fluid that the kidney cannot cope with.
Decreased peristalsis, occurs in bedridden patients

Prolonged pyelectasis can lead to impaired kidney function, as well as to its inflammation, so if you feel unwell, it is better to consult a nephrologist or urologist.

The danger of pyeloectasia is that with prolonged obstruction of urine outflow from the kidney, tissue compression occurs, accompanied by kidney atrophy, as a result of which the kidney may die.

Enlargement of the renal pelvis - diagnosis

In most cases, it is possible to detect this pathology during a planned (once a year) examination. ultrasound examination(ultrasound). But, if the etiology is unclear, the doctor may prescribe additional methods diagnostics, such as urological examination, cystography, urography or radioisotope research kidney

If this disease is detected in a child at birth, surgery is performed extremely rarely. It usually goes away on its own when the child’s urinary system organs mature.

The operation is performed in 40% of cases. Based on diagnostic data, the doctor decides whether to carry out it or whether conservative treatment can be done.

At surgical treatment an obstacle is eliminated, for example, a stone or vesicoureteral reflux that contributes to the expansion of the pelvis.

The kidneys are a paired organ with a complex structure that performs the functions of creating, storing and removing urine from the body. Important role The pyelocaliceal system (PSS) plays a role in its functioning: it collects urine formed in the nephrons and further evacuates it through the ureters into the bladder. There are several dozen diseases that occur with damage to the calyces and pelvis, and pyeloectasia of the kidneys is one of them.

It is known that the normal size of the renal pelvis is 3-6 mm in children and adolescents and 10 mm in persons over 18 years of age. Pyeelectasis is a pathological expansion of the renal pelvis in adults and children. According to statistics, this syndrome is more typical for strong half humanity. Due to anatomical features urinary organs, pyeelectasis of the right kidney develops several times more often than the left one.

Causes and mechanism of development

Pyeelectasis is not considered in medicine as an independent disease. This condition is only a syndrome, and is characteristic of many pathologies of the urinary organs. Enlargement (ectasia) of the renal pelvis can be caused by:

Congenital malformations

horseshoe kidney;
ureteral strictures;
dystopia of the ureter;
agenesis of the ureter;

Acquired diseases

urolithiasis;
benign/malignant tumors of the urinary organs;
back and abdominal injuries;
chronic inflammation of the kidneys – pyelonephritis, glomerulonephritis;
prostate adenoma.

Pyeloectasia of the kidneys often develops during pregnancy. Expectant mothers more often encounter right-sided damage to the urinary organs: this is due to the deviation of the growing uterus to the right. Unlike pathology, expansion of the maxillofacial area in pregnant women, even up to 25-27 mm, as a rule, does not require treatment and goes away on its own after childbirth.

The pathogenesis of the disease is based on a violation of the physiological outflow of urine from the renal pelvis to the ureter, bladder and urethra. The accumulating fluid gradually causes dilatation and expansion of the renal collecting system. This, in turn, leads to compression of the parenchymal structure, nephron atrophy and the development of progressive renal failure.

Classification

Depending on the extent of damage to the organs of the urinary system, two forms of pathology are distinguished:

unilateral pyeelectasis of the left or right kidney;
bilateral pyelectasia - of both kidneys.

The syndrome is also classified according to severity (mild, moderate, severe). In this case, it is necessary to take into account not only the severity pathological process, but also the volume of preserved functionally active tissue, the presence of a concomitant inflammatory process, signs of renal failure.

Symptoms typical of pyelectasis

The clinical picture of pyelectasis is nonspecific and largely reflects the disease that caused it:

Urolithiasis is manifested by periodic intense pain in the lower back (renal colic).
With kidney tumors, patients complain of aching pain in the back, radiating to the groin and abdomen. Sometimes it is possible to excrete red blood in the urine.
If the renal pelvis is dilated due to chronic inflammation, signs of intoxication, lower back pain, cloudy urine, the appearance of sediment and mucus in it come to the fore.

Often the pathology is asymptomatic for a long time and becomes an accidental finding on ultrasound. Infection of the dilated collecting apparatus leads to the following symptoms:

fever up to 38.5-41 ° C;
chills;
dizziness;
nausea, vomiting that does not bring relief;
loss of appetite;
decreased performance.

Diagnostic measures

Before starting treatment for the pathology, it is necessary to establish the main cause of the expansion of the heart rate. Standard diagnostic plan kidney diseases includes:

Collection of complaints and medical history. It is important for the doctor to outline the boundary possible problems and make a preliminary diagnosis.
Inspection, palpation, percussion, determination of the tingling symptom. Allows you to diagnose enlarged kidneys, the presence of an inflammatory process or stones in them.
Blood tests (general, biochemical). With their help, you can learn about existing health problems and possible somatic pathologies.
Urine tests (general, according to Nechiporenko, according to Zimnitsky).
Instrumental diagnostic methods - ultrasound, CT, MRI, excretory urography.

Instrumental tests are the main method for detecting pyelectasis. If the renal pelvis is dilated, this can be easily determined, as well as the exact size of the organ can be determined using visual diagnostic methods.

Principles of therapy

Treatment of pyeelectasis, like most pathologies, requires an individual approach. The doctor must take into account the cause of the disturbance in the outflow of urine, the age of the patient, concomitant diseases and injuries, and the degree of disruption of the functioning of the nephrons. Therapy can be carried out both conservatively and surgically.

Conservative (medicinal) treatment consists of prescribing antibacterial, anti-inflammatory, antispasmodic and uroseptic agents. The average duration of their use is 10-14 days.

But still, most conditions accompanied by pyeelectasis require surgical treatment. Using safe and effective techniques, the disease is eliminated (for example, widening the lumen of the ureters, removing stones). The impaired outflow of urine is restored quickly and painlessly. In the future, the patient needs regular examinations by a therapist and preventive possible complications.

If you have an enlarged renal pelvis, consult your doctor immediately. Timely diagnosis and treatment of pathology will restore impaired functions of the urinary organs and prevent the development of complications. And kidney health, in turn, is important for the smooth and coordinated functioning of the body.

Enlarged renal pelvis causes treatment

Not all of us know what the renal pelvis is? If we talk about its visual representation, then it resembles a certain type of funnel, which serves as a reservoir for collecting liquid, which must subsequently be discharged outside. The pelvis in the human body is connected by a narrowed neck to the cups, and if for some reason this passage is blocked, then it expands, which is manifested by quite strong pain.

Enlargement of the renal pelvis is a serious pathology, which is almost always diagnosed in an advanced stage, since initial stage not observed in humans severe symptoms. In the event that the pathology is not diagnosed in time and does not begin effective treatment, the disease can lead to serious consequences. As they develop, the symptoms become more pronounced, and the person experiences rapid fatigue and an increased urge to urinate.

Kidney structure

If the treatment is not effective or the patient self-medicates, then vascular sclerosis or renal failure may develop, and in advanced situations even cause death.

Note! An enlarged renal pelvis requires immediate treatment, even if the pathology does not bother the person in any way.

If the pathology develops as a result of blockage of the cervix with a stone, then in this case the only way out is to perform an operation.

Currently thanks to modern technologies Carrying out this type of operation is completely safe for human health and is carried out with minimal intervention. Besides rehabilitation period very short after the operation. But, despite all this, before undergoing surgery, each patient must undergo thorough preparation and all necessary examination procedures.

We have already found out what the renal pelvis is, now let’s determine the reasons for its expansion.

This pathology can be diagnosed as either congenital or acquired. As shown medical practice, expansion of the renal pelvis occurs due to improper outflow of urine. But this reason is not isolated, since such a pathology can also arise for the following reasons:

if you have kidney stones;
constant overcrowding of the bladder;
in the presence of tumor formations in the organs of the urinary system;
narrowing of the urinary tract as a result of various injuries;
with inflammatory processes in the urinary system;
increase in intrarenal pressure.

Among other things, the development of a disease such as enlargement of the renal pelvis leads to enlargement of the renal pelvis. Despite the fact that such situations occur extremely rarely, they still require close attention. With this pathology, the patient experiences the appearance of bleeding in urine, which are not accompanied by the passage of stones, as well as systematic pain in the lumbar region, which more closely resembles renal colic, but do not stop when changing body position. Also in this case, the patient experiences unjustified weight loss and maintains the same diet.

Pathologies of the renal pelvis can occur due to kidney stones

Sometimes a hereditary predisposition leads to such a pathology. It is in order to avoid such a pathology that everyone is advised to take care of their health and systematically undergo certain examinations.

Detecting dilation of the renal pelvis at the initial stage of the disease is quite problematic. This is because the symptoms remain invisible for a long time. But still, if you listen carefully to your health and systematically undergo examinations, there is a chance without harm to your health and early stage reveal that the renal pelvis is enlarged.

To the most common reasons applies:

the appearance of pain in the lumbar region;
discomfort when urinating;
poor urine flow;
frequent urge to urinate;
the occurrence and presence of various types of infections.

The disorder is accompanied by frequent trips to the toilet

It is precisely because the pathology has a limited number of symptoms that this deviation is considered difficult to diagnose. But, despite this, if at least one of the symptoms listed above appears, you must immediately seek help. medical care. In this case, a correct diagnosis and the appointment of effective and timely treatment are very important.

In order to correctly diagnose an enlarged renal pelvis in adults, after examination, the doctor must prescribe a number of examinations. Basically they are the following:

to identify the presence of concomitant diseases and infections is prescribed general analysis urine;
Cystography is prescribed to determine the condition of the bladder;
urography is prescribed;
An ultrasound scan is mandatory, which can accurately determine the presence or absence of pathology.

An ultrasound scan is required to detect pathology.

Of course, only in combination do all studies help establish an accurate diagnosis and determine the development of possible complications. After this, the doctor determines which drugs will be most effective in dilating the renal pelvis.

In order to get rid of the pathology, it is first necessary to determine the reason why this all happened. Only after this can you select necessary treatment. As soon as it is possible to cure the cause that provoked the dilation of the renal pelvis in adults, the pathology will automatically be treated.

It is categorically unacceptable to start pathology, since the pathological process will develop quite rapidly and can cause numerous serious complications. If the disease is diagnosed during pregnancy, even despite the possibility of complications, treatment is not carried out, since in most cases pyelectasis goes away on its own after the birth of the child.

In a child, the disease can be diagnosed in the womb, but in most cases it goes away after birth

But as medical practice shows in other situations, when the cause of dilation of the renal pelvis is birth defects development of the urinary system or the presence of urolithiasis, then in this case drug treatment will not give any results. The only way out of this situation is surgical intervention.

After the operation, the patient is recommended to follow a certain diet, since only proper nutrition will help to recover in a short period of time and prevent further development of the disease. When creating a menu, you should absolutely avoid all fatty, smoked or salty foods, and also try not to use salt when cooking. Among other things, you should definitely reduce your fluid intake. It is recommended to drink no more than 1.5 liters of liquid per day.

It is also worth paying close attention to increasing immunity, as well as following the following fairly simple rules:

during epidemics associated with colds refuse to visit large crowds of people;
systematically take complex multivitamins;
give preference only to healthy eating;
observe correct mode day and systematically rest and not overwork;
constantly walk in the fresh air;
do not overcool;
do not lift heavy objects;
systematically visit the doctor for preventive purposes.

Give preference to healthy eating

Also, for prevention purposes, it is necessary to completely abandon all bad habits and carefully monitor your own hygiene. Among other things, in order to eliminate the risk of developing pathology, it is also necessary to never slow down the process of emptying the bladder and avoid stagnation of urine.

Possible complications

As stated earlier untimely treatment enlargement of the renal pelvis can lead to the development of numerous complications and diseases. This is explained by the fact that as a result of a violation of the outflow of urine, various unpredictable consequences can occur.

One of these consequences is the development of pyelonephritis. This pathology, after its occurrence, is accompanied by quite pronounced symptoms. If treatment is not started, then there is a risk of atrophy of the kidney tissue or sclerosis of the kidney, which in turn can provoke complete death of the kidney tissue.

Conclusion

The renal pelvis, which is a kind of container in which urine is collected. After this, the urine passes into the ureter and bladder. If a pathological process develops in the body along the path of urine movement, then its obstruction leads to expansion of the renal pelvis. If treatment is not started in a timely manner, this pathology can cause serious complications and also lead to death. Treatment in most cases occurs surgically, but despite this, this operation does not pose any threat to human health and life. Moreover, such treatment methods do not require long-term recovery period and long-term rehabilitation. The only thing that must be followed is a diet that has a positive effect on the body and prevents relapse of the pathology.