The renal pelvis is part of the kidney cavity system. It is located on the site of the renal gate. Its physiological volume is from four to eight milliliters. The pelvis of the kidney collects urine from the cups for subsequent transportation down the ureter. Renal vessels go along its front part, therefore it is more convenient and safe to dissect the wall along its lower or rear surface.
The renal pelvis may be extrarenal or intrarenal. As a rule, it looks like a triangle (funnel). However, its shape may be saccular, ampullar or branched. By pyelourethral segment of the pelvis of the kidney passes into the ureter. This segment is a very significant area and requires caution in surgical intervention.
Hydronephrosis is a disease that results in an increase in the renal pelvis. This condition provokes thinning of the tissue and damage to renal function. The occurrence of hydronephrosis is due to a violation of the natural urinary outflow from the pelvis. Such a violation leads to a violation of the blood circulation in the renal tissues. Children and women are more prone to hydronephrosis.
Enlarged pelvis in children can be noted both on the right and on the left kidney. In severe cases, bilateral hydronephrosis is observed, which, as a rule, develops as a result of urological pathology.
Hydronephrosis is classified into congenital (primary) and acquired (secondary).
In the first case, the disease occurs due to an abnormality in the development of the upper urinary tract. Secondary disease is a complication of any other disease of a urological nature (urolithiasis, prostate or urinary tract tumors, inflammatory diseases).
Regardless of the classification, hydronephrosis is infected or aseptic and can develop in three stages.
As practice shows, in children most often develops a primary (congenital) disease. It is a consequence of the improper location of the ureter, its compression or narrowing.
An increase in the pelvis of the kidney in the fetus can be detected at the twentieth week of development. An ultrasound reveals an abnormality, but an accurate diagnosis is made in rare cases. This is due to the fact that the pathology disappears on its own with the further formation of organs.
In some cases, an increase in the pelvis is observed in newborns. Signs of the disease in such cases are blood in the urine and an enlarged abdomen.
It should be noted that such a condition in childhood is quite easy to treat and in most cases does not require surgical intervention.
The expansion of the pelvis of the kidney in the fetus occurs due to the formation of an obstacle to the urinary outflow. As a rule, the disease can be detected by ultrasound at 18-22 weeks of development.
Moderate expansion, as a rule, does not affect the health of the child after birth. Usually in the prenatal period, moderate pyeloectasia disappears on its own. With a disease of a pronounced nature, the outflow of urine from the kidney is much more difficult. This, in turn, causes impaired renal function, compression and tissue atrophy. The inflammatory process (pyelonephritis) often joins this disease.
As observations show, often pyeloectasis is observed in fruits with Down syndrome. It should be noted that the detection of expansion of the pelvis does not increase the risk of the presence of the syndrome and does not apply to the indications for the appointment of other diagnostic measures.
As a rule, with moderate pyeloectasia, every third month after birth is prescribed for the prevention of ultrasound. In the presence of urinary infection, antibiotics may be prescribed. In the case of an increase in the degree of pyeloectasia, a detailed urological study is prescribed.