In modern medical practice, diseases of the genitourinary system are common. Among them, a pathology such as an enlarged renal pelvis, which is accompanied by obstructed outflow of urine, is often found. The pelvis is the place in which urine is collected from the kidneys, following in the ureters. The disease affects children and adults. More often the pelvis of the kidney is enlarged in a male child.
The disease can be one-sided or bilateral, when one or both pelvis is affected. According to the degree of complexity, light, medium and severe forms are distinguished.
The causes of expansion 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, and neurogenic bladder dysfunctions.
With dynamically acquired enlarged pelvis, the kidney 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 prostatic adenoma.
Organic congenital include abnormalities of the ureter, kidney, and upper urinary tract walls.
Acquired organic occur in inflammation of the ureter and tissues surrounding it, tumors of the genitourinary system, nephroptosis (prolapse) of the kidney, and urolithiasis.
Most often, the enlarged pelvis of the kidney is asymptomatic. Anxiety is brought by signs of the underlying pathology that has caused the development of the disease. Infectious and inflammatory processes that develop with prolonged stagnation of urine in the pelvis also make themselves felt.
In most cases, the pathology is detected during pregnancy or during the first year of a child's life. Some experts attribute this ailment to innate structural features. Often, the enlarged pelvis of the kidney 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 a stone blocks the lumen of the ureters.
First of all, the following points should be alarming. When conducting an ultrasound examination (ultrasound), the volume of the pelvis changes before and after the urination process. If the size of the organ is 7 or more mm, and the change occurs during the year.
An enlarged renal pelvis can lead to complications: decreased renal function, inflammation (pyelonephritis), renal tissue atrophy (size reduction), kidney sclerosis, a condition accompanied by the death of the urine-producing kidney tissue.
Enlarged renal pelvis: diagnosis and treatment
With the size of the pelvis up to seven mm, control studies of the kidneys and bladder are performed, which are performed every 1-3 months. Ultrasound for children is prescribed every six months after a year. With the progression of the disease, urography and cystography, X-ray methods of research using a contrast agent, which is injected through a catheter into the bladder, are performed.
With urography, the contrast agent is administered intravenously. Using these studies establish the true cause of the development of the expansion of the pelvis.
Treatment of the enlarged pelvis of the kidney is primarily aimed at eliminating the cause that led to a violation of the outflow of urine. Congenital abnormalities are corrected by surgery. When narrowing the ureter , stenting is used, which involves the introduction of special scaffolds into the narrowed areas. With the extensions that are a consequence of urolithiasis, they select a method for removing stones, which can be conservative or surgical treatment. A variety of physiotherapeutic procedures are often used. In some cases, herbal treatment is prescribed.
Particular attention is paid to the prevention of the development of inflammatory processes. Surgical interventions are performed using endoscopic methods using miniature instruments.