Anomalies associated with the development of the urinary tract make up more than 35% of all congenital malformations in humans. Moreover, there are cases when such pathologies are asymptomatic and are determined only during puberty or pregnancy. Freyli's syndrome is an abnormality of the kidneys of a congenital nature, in which a cross of the front and rear branches of the upper renal artery is formed. As a result, the normal functions of the organ are disrupted.
The syndrome got its name from the name of the American urologist who first described it. The article will discuss the causes, symptoms and treatment of the disease.
What it is?
As already mentioned, with Freyley's syndrome, the posterior and anterior branches of the renal artery cross. In this case, partial compression of the upper parts of the pelvis or pelvis-ureteric segment is possible. As a result of this , kidney function may be impaired or even lost. There is a likelihood of the formation of stones, the appearance of arterial hypertension. Traces of blood may be detected in the urine.
A similar anomaly occurs even during embryogenesis of the vascular system of the kidneys, when it is possible to stop their development, but to preserve the structures.
Freyly’s syndrome is located on the right and on the left, that is, it usually affects one kidney. In extreme cases, both organs can suffer. In this case, the syndrome may be accompanied by a defect in the filling of the upper group of calyxes and right-side or left-side pyeloectasia due to obstruction of the ureter.
Symptoms of the disease
There are some signs that indirectly indicate that the patient may have Freyly’s syndrome. Symptoms are manifested by palpable pain in the lumbar region, renal colic, which are present in connection with secondary nephrolithiasis. In addition, there is minor arterial hypertension, as well as macro- and microhematuria.
Diagnosis of the syndrome
It is most difficult to clinically detect Freyli's syndrome in young children, especially in infants. To make the correct diagnosis using the method of dopplerography of the vessels of the kidney, also use multispiral computed tomography.
It is difficult for kids to conduct angiographic studies, so they are currently almost never used.
In addition to the above methods, patients are prescribed urine and blood tests, including drug sensitivity and flora. In addition, ultrasound of the urinary system is performed.
Treatment methods
Treatment of this disease is prescribed only after a thorough comprehensive examination and confirmation of the diagnosis. The conservative method - antihypertensive therapy - is used in rare cases. It is aimed, as a rule, at reducing pressure in the event that it is increased. They also carry out a set of measures to eliminate secondary pyelonephritis and are involved in the prevention of urolithiasis.
However, the most reliable way to completely eliminate Freyli's syndrome is treatment is not conservative, but surgical. During the operation, the doctor removes the crossing of the arteries in the kidneys and the pressure on them stops.
In any case, patients (and especially babies) should be registered with a nephrologist and receive regular consultations, take the necessary tests, and undergo ultrasound and radiographic examinations. In later life, Freili’s syndrome may not manifest itself at all, the degree of discomfort depends on how much the renal pelvis is pinched . With a healthy lifestyle and the absence of bad habits, patients may not feel any symptoms at all.
Pregnancy
Pregnancy and the birth of a child with Freyly’s syndrome in a mother pass only under the supervision of a specialist. As a rule, women with congenital malformations of the kidneys, which include this syndrome, are allowed to bear the fetus only after surgery. The fact is that Freilly’s syndrome is often accompanied by an increase in blood pressure, pregnancy in this case is more difficult, sometimes it has to be interrupted for a period after 22 weeks.
But even after a successful operation and restoration of kidney function, a pregnant woman needs to warn her obstetrician-gynecologist about this. The patient must be under the control of a nephrologist throughout the entire period of bearing a child, periodically undergo tests, undergo research, and, if necessary, be hospitalized in a hospital.
Very often, exacerbation of kidney disease can appear at a period of 15-16 or 26-30 weeks. Symptoms include delayed urine, severe swelling of the arms and legs, pain and discomfort during urination. In later stages, complications are possible due to the rapidly growing uterus, which presses on the ureters. In the event of the appearance of such signs of a pregnant woman with Freyley's syndrome, urgent hospitalization is necessary.
Childbirth in Freuly's syndrome
Very often, kidney defects are an indication for cesarean section. However, the threat to the child in this case is insignificant.
There are specialized maternity hospitals for women in labor with Freyley’s syndrome and other abnormalities in the development of the kidneys, which urologists and nephrologists must attend, and a comprehensive examination is carried out immediately after birth.
So, in the article, a kidney disease such as Freyly’s syndrome was considered. Despite the fact that the anomaly is congenital, at present it is successfully treatable, and patients after surgery can return to a normal lifestyle.