How to understand that in adults the renal pelvis is dilated and how to treat
Renal pelvis is a special cavity in which urine accumulates from the kidneys. In the renal pelvis, urine penetrates from the renal calyces, and from the pelvis it is transported to the ureters and further into the bladder. If the kidney is dilated in adults, the treatment depends on the diagnosis and the form of the pathology.
Reasons for the formation of pathology
This disease, as an expansion of the renal pelvis, occurs when the outflow of urine to the ureter from the renal pelvis is disturbed. Urinary leakage is disturbed due to the obstruction of the ureter, the narrowing of its lumen.
In a child's body, the disease occurs because of congenital abnormalities in the formation of the urinary system. To immediate reasons should be attributed to the narrowing of the ureter lumen, its inflection due to improper placement of the kidney.
Also, the reasons for the increase in renal pelvis include the increase in urinary pressure due to the formation of an obstruction in the way of its passage, the narrowing of the urinary canals, the return of urine to the kidneys. To identify the pathology of the fetus in the 16-20th week of its development, an ultrasound examination is organized.
Pyeloectasia is considered a problem, as it develops in the urinary organs stagnation and begins the process of atrophy of the kidney tissue, and the functioning of the kidneys worsens. As a result of these abnormalities, sclerosis of the kidney occurs.
In an adult, pyeloethasy most often develops after the transfer of urolithiasis. In this case, the stone is able to be located in the tubular cavity or even in the ureter itself. An increase in the renal pelvis in adults can develop due to the effect of tumor growths when the tumor strongly presses the ureter and causes a urinary retention disorder.
Diagnosis and manifestation of the pathology of
In most situations, an increase in the renal pelvis is not itself characterized by specific symptoms, and the clinical picture is a manifestation of the underlying pathology that provoked pyeloectasia.
In addition, stagnation of urine in the pelvis promotes the formation of an infectious-inflammatory process. Often the disease is detected quite accidentally during an ultrasound.
The expansion of the renal pelvis in adults is caused by the overlap of the ureter with a stone, so, with the development of urolithiasis and other provoking factors, it is mandatory to perform an ultrasound examination for the kidney in order to prevent serious complications.
When organizing ultrasound, doctors pay attention to the size of the kidney pelvis in adults before and after urination, as well as changes in size over the past year. Due to the frequent progression of the pathology, additional diagnostic methods are used to determine the cause of the lesion, such as urography - intravenous contrast agent injection, cystography - the introduction of a contrast agent into the bladder using a catheter.
Treating the pathology of
In order to eliminate the enlargement of the renal pelvis in adults, it is first necessary to combat the cause that led to this lesion, which triggered a urinary retention disorder.
Congenital etiological factors of pathology can be successfully corrected by surgical intervention. When narrowing the ureter, stenting can be done - when a special "frame" is inserted into the narrowed zone.
In 70% of cases congenital pyeloectasia is eliminated spontaneously due to ripening of the urinary system of the child in the first year after his birth. In 25% of cases of the disease, conservative therapy is necessary, which is the administration of medications prescribed by a nephrologist. And only 5% of cases of pathology in children may require surgical intervention by means of an endoscopic technique, that is, without an open operation of the canal.
If the norm of the renal pelvis in adults is increased due to urolithiasis, the doctor decides on the most appropriate method of removing stones. In this situation, both conservative and operational methods can also be implemented.
Before the elimination of the causes of the disease, the treatment of the enlarged renal pelvis consists in preventing the formation of inflammation processes. To this end, experts recommend the use of medicines that could contribute to the destruction of pathogenic microorganisms falling into the urine. In addition, excessive fluid intake, as well as diuretics or medications, should be avoided.
Operations in case of adult damage by pyeloethasy are required in 25-40% of cases. Now there is no way that would help predict the course of the disease, so the question of surgery is decided by the doctor only after careful monitoring of the patient and conducting his examination. In the case of pronounced pyelonectasia or active expansion in the pelvis and worsening of the kidneys, surgical intervention may be necessary.
The operation makes it possible to eliminate the resulting obstruction to urinary outflow or to get rid of vesicoureteral reflux. Many surgical interventions are successfully carried out through endoscopy, that is, without open operations, but with the help of small tools that get to the site of the lesion through the channel of urination.
Danger of development of pathology
This disease is considered a manifestation of abnormalities in the functioning of the urinary system. The difficulty of withdrawing urine can increase, provoking squeezing, atrophy in the kidney tissue and worsening of the kidney. In addition, an incorrect outflow of urine is often supplemented by pyelonephritis, an inflammatory process in the kidney that worsens its function and can lead to sclerosis of the kidney.
It is important to remember that the enlargement of the renal pelvis is not an independent disease - it is just an indirect symptom of the appearance of a disorder due to a negative effect on the urinary leakage from the pelvis. Proceeding from the above, it becomes clear that the main treatment of pathology depends on the specific reasons for its development.