Hydronephrosis transformation of the kidney: causes of development, manifestations and treatment
Hydronephrosis transformation of the kidney is a congenital or acquired pathology of the kidneys, characterized by the enlargement of the calyx and kidney loops. The disease is formed due to the formation of an obstruction on the way of urinary retention, causing the death of the organ.
Because of the pressure of the vessels, the kidneys are disturbed, the parenchyma atrophy develops and the kidney function is deteriorating noticeably. Basically, hydronephrosis is manifested in young women and usually only one kidney is damaged. Hydronephrosis of the left kidney and right kidney occurs equally often.
Why this pathology develops
Hydronephrosis of the kidneys can be congenital or acquired. The congenital form develops due to the influence on the body of the following factors:
- violation of the patency of the urinary canals;
- congenital abnormalities of the arteries of the kidney and their branches, which press on the ureter;
- incorrect localization of the ureter behind the hollow vein;
- presence of congenital valves in the ureter or obstruction of the urinary tract.
Acquired form of hydronephrosis is formed as a result of the following urological pathologies:
- urolithiasis;
- inflammation in the urogenital organs;
- tumor neoplasms in the urinary canals, in the uterus, in the cervix or ovaries, in the prostate gland;
- cicatricial narrowing of the lumen of the urinary canals due to injury;
- metastasis or malignant form of infiltration in the cellulose of the small pelvis or in the space behind the peritoneum;
- spinal cord injuries, which provoke a reflex violation of urinary retention.
What signs indicate the development of the pathology
Often, the hydronephrosis transformation of the right kidney or left kidney is asymptomatic. Specific signs of pathology does not. In the early stages, clinical manifestations are explained by the causes that provoked hydronephrosis. For example, with the development of urolithiasis, acute renal colic can develop, accompanied by severe pain in the direction of the ureters.
Signs and manifestations of hydronephrosis are related to the nature of the obstruction and are acute or chronic, partial or complete. In addition, the defeat can be one-sided or two-way. The unilateral form proceeds without symptoms, but with an acute full block, severe pain in the lumbar region can develop.
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Blood tests indicate an increase in the level of slagging of blood and the development of an imbalance of electrolytes. Urinalysis also shows an increase in acidity due to the secondary disintegration of nephrons in the kidney.
Pain receptors of the kidney are located in the shell and make themselves felt during the stretching of this shell, so the signs of the disease depend on the location of the obstruction and are characterized by pain in the side and in the lumbar region. Enlarged kidneys are easily palpated.
Hydronephrosis transformation of both kidneys can eventually lead to the development of renal failure, kidney infection and the formation of stones in them.
Stages of development of the disease
- The first stage of the pathology manifests itself through a small accumulation of urine in the renal pelvis, which causes a slight stretching of the walls. This stage is compensated when the kidney function remains normal.
- In the second stage, hydronephrosis transformation of the kidneys provokes thinning of the parenchyma, supplemented by a worsening organ work by approximately 40%.In this case, the work of the second healthy kidney increases, compensating for the excretory function.
- The third stage of development of hydronephrosis is terminal and is characterized by a marked loss of functions by the kidney or its complete atrophy. Healthy kidneys at the same time ceases to cope with the needs of the human body, begins to actively develop kidney failure, which in the absence of the necessary therapy can lead to death.
Diagnosis and treatment of hydronephrosis
When the organ is touched and the external examination of the patient is examined, the doctor can establish deformities and tumors in the lumbar region. Hydronephrosis transformations are diagnosed by palpation of a large neoplasm. This requires a differential examination with other diseases, such as ptosis of the stomach, a tumor in the uterus or space behind the peritoneum.
Laboratory diagnosis is the delivery of common blood and urine tests, as well as special urine samples.
The main objective of the therapeutic process of kidney hydronephrosis is to ensure the normal retention of urine from the kidney by removing obstacles, as well as conducting urine drainage accumulated during obstruction. Specification of treatment depends on the location of the obstacle, as well as on its nature.
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An obstacle that is a stone is eliminated by endoscopic operations - percutaneous nephrolithotomy, remote lithotripsy, and the like.
Acute obstruction of the upper urinary tract, which was complicated by an acute inflammatory process in the kidney, is usually treated by installing a nephrostomy tube or stent into the ureter. Thus, the body is draining, inflammation is eliminated and the kidney function is restored. The next stage of treatment is surgical intervention and the resumption of urinary diversion.
The occlusion of the lower part of the urinary canals, which provoked the development of hydronephrosis, for example, prostatic adenoma or compression of the urethra, is usually eliminated by placing a urinary catheter. And the next stage of treatment is to realize the elimination of the cause that caused the violation of urinary diversion - the adenoma of the prostate gland is removed by resection or laser removal of the adenoma.
Narrowing of the urinary tract or ureter can be congenital or acquired. In addition, congenital pathologies that cause the development of hydronephrosis include the presence of a cross-over or otherwise conflicting additional vessel in the kidney.
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The main causes of narrowing include the following: urolithiasis, acute or chronic forms of the inflammatory process in the urinary canals, tuberculosis of the urogenital system. Also, constriction can develop as a complication after urological, gynecological and other surgical operations.
Regardless of the nature of the pathology and the causes of its development, the narrowing of the ureter or the anastomosis of the pelvis and ureter is eliminated through the following operations:
- Endourological operations - laser dissection, endopylotomy, etc.
- Laparoscopic operations - ureteral plastic or pelvis and ureter anastomosis.
- Open surgery - a variety of types of plastic, for example, intestinal plastic, etc.