A disease of two tubular organs that helps urine to leave the kidneys and move into the bladder is called ureteral dilation. Due to problems with the transport of urine, a person has dangerous violations in the functioning of the urinary system. This is quite a serious ailment.
What is the name of the expansion of the ureter? Megaureter - an acquired or congenital lesion that provokes problems with the functioning of the kidneys, and with bilateral inflammation in a person leads to renal failure. With the expansion of tubular ureters, urine outflow does not occur, which can lead to an inflammatory process in the kidneys and problems with the circulatory system.
Extension of the tubular process
The walls of the ureter are distinguished by a three-layer structure, which helps the urine to move slowly to the bladder. The external muscle shell includes nerve and collagen fibers, which help move urine up to five contractions per minute. With an increase in the size of the ureter, the contractile force begins to decrease, the movement of urine becomes difficult, the patient's intrarenal pressure rises. Long stagnation of urine provokes the onset of infection, which only worsens the condition of a person. If you do not start timely treatment of the lesion, then soon there will be problems with the work of the kidneys.
Often, infectious processes in the ureter only increase the expansion of the organ. The expansion of the ureter and renal pelvis is diagnosed by ultrasound examination of the fetus.
If after birth the child does not have a megaureter, then in the future expansion of the tubular organs will not occur. In a normal state, the diameter of the ureter does not exceed 5 mm, if during the examination an expansion was revealed, then the doctor prescribes a more extensive examination of other internal organs.
In adolescents with this form of lesion, the following symptoms are most often present: the presence of blood discharge in the urine, incontinence, complaints of persistent pain in the abdomen and lower back, and the formation of stones in the urinary organs.
The main types of defeat
Specialists distinguish such forms of damage:
- The primary form is a congenital disease. It occurs in the absence of coordination of the muscular and connective tissues of the ureter. In this case, the body lacks the strength for the normal movement of urine through the tubes. A megaureter can appear in a child even at the time of its development in the womb. Most often, a disease of a congenital form appears in boys.
- Secondary view - occurs at high pressure in the bladder. Most often, regular nervous breakdowns, emotional outbursts or chronic cystitis lead to this condition. Most of the diseases after a comprehensive diagnosis and the appointment of effective treatment takes place in the first years of a newborn’s life.
Reasons for the expansion
There are several reasons for the expansion of the ureter. The main include high pressure of the ureter and problems of the outflow of urine. There were situations when, after normalization of pressure, the ureter continued to remain dilated.
Often, the patient reveals congenital insufficiency of the muscles of the tubular organ. In this case, the ureter is greatly weakened and loses contractile ability to move urine to the bladder. Another reason for this condition is the narrowing of the tubes at the place of their attachment to the bladder.
The main causes of ureteral enlargement:
- increased pressure inside the tubular organ, which provokes the expansion of the ureter and kidney, as well as problems with the outflow of urine;
- weakness of the membranes in which the muscles are located;
- problems with the formation and development of nerve endings;
- urine is thrown into the pelvis due to narrowing of the ureter.
Characteristic symptoms of the lesion
There are a large number of reasons for the expansion of the ureter in a child. In the absence of a primary lesion, the megaureter proceeds in a latent form. In this case, the person has no pronounced symptoms of the disease, he does not suspect anything about his condition. In another case, a person may feel unpleasant pains in the abdomen and lower back, he can also easily feel the tumor-like formations or notice an admixture of blood in the outgoing urine. With the development of an acute form of damage in humans, a high number of leukocytes in urine is diagnosed, nausea, vomiting, and body temperature increase.
The most unpleasant symptoms of this disease appear at stages 2 and 3 of its development, it was at this time that a dangerous complication such as chronic kidney failure or pyelonephritis occurs in a person.
With the expansion of the processes or a double lesion, the child often has double urination. This condition occurs due to the fact that after the first emptying of the bladder, it is again filled with urine from the expanded organs and the need for urination reappears.
The second time, urine leaves in large quantities, with an unpleasant odor and a cloudy sediment. Due to the fact that the weakened body of a newborn baby is very susceptible to various infections, problems with physical development or skeleton abnormalities may begin in it. Most often, with the expansion of the ureter in newborns, appetite is lost, the skin turns pale, thirst and urinary incontinence appear.
The degree of development of the problem
After carrying out diagnostic measures, the attending specialist assesses the condition of the kidneys and prescribes effective treatment. Doctors distinguish three main stages of the development of the disease:
- Easy stage. There is a moderate expansion of the lower ureter. This condition often goes away on its own without external influence.
- The average degree of damage. The diameter of the ureter is greatly expanded. With timely and high-quality treatment, you can easily get rid of the problem.
- Severe degree. Megaureter can provoke impaired kidney function. In this case, after the examination, the doctor will prescribe the patient an operative measure.
How does a young child go?
With the advent of modern equipment in clinics, diagnostics can determine the presence of a megaureter and anomalies of the genitourinary system even at the stage of intrauterine development. Conducting early diagnosis and identifying megaureters can lead to unnecessary surgery. This can be explained by the fact that in most cases the process of expansion of the ureter in the child stops, and the size of the ureter is restored within a few months of the baby’s life.
At this age, the doctor should regularly monitor the condition of the baby and prescribe a urinalysis and ultrasound. Timely identification of the lesion will help to avoid complications and exacerbations of the disease, as well as prevent the operation unnecessary for the child. In a baby, organs continue to develop actively for some time, for this reason in the first few months of life, the doctor can not always accurately determine the state of the urinary system and the work of the kidneys.
When conducting diagnostic measures, the attending physician should be especially careful and careful, since the risk of error in this case is very high. The defeat can be eliminated only with the timely determination and appointment of effective and proper treatment. It often happens that the expansion of the ureter in the newborn passes on its own. Very often no external intervention is required. In an adult, an acute operation is performed in the acute stage of expansion of the left ureter.
Indications for the operation
Indications for surgery with the expansion of the ureter in the medical field are divided into two separate types. These are absolute and relative.
Absolute readings
Absolute indications include a disease that is at 2 or 3 stages of development. This condition is very dangerous for the health and life of the newborn child and adult.
Surgery in this case will be the only way to eliminate the disease and completely normalize the patient's condition.
Relative indications
A relative indication is a disease that is at the 1st stage of development and does not pose a particular danger to human life, but significantly affects its condition. For example, it brings fatigue, headaches, reduces performance, provokes nausea.
The ureter in this case is expanded minimally. The patient has time during which he can take a course of effective drugs, which will help prevent an even greater expansion of the ureter. This will help prepare the patient for the operation.
Basic research methods
In medicine, the expansion of the ureter is detected at various stages using laboratory methods for examining the patient. The most effective and accurate are excretory urography, radioisotope examination of the kidneys, cystourethrography.
Conducting electronic urography
An effective diagnostic method is urography, which does not cause unpleasant sensations in the patient and helps to obtain accurate information about the condition and functioning of organs, the localization of the lesion, the anatomical structure of the ureters, as well as about the expanded areas.
Contraindications to the procedure are severe kidney diseases, nervous breakdowns, problems with concentration ability and other processes in which, due to the accumulation of a large amount of urine in the blood, it is impossible to accurately determine the clinical picture of the disease.
Women carrying a child are prohibited from carrying out the procedure, or only with special indications. For example, with suspected malignant or benign lesions in the ureter.
Mixed cystourethrography
Another method for diagnosing ureteral expansion is cystourethrography, which helps to examine the presence of expansion and reflux (reflux of fluid from the bladder) on x-rays.
In children who cannot independently empty the bladder, the procedure is performed under general anesthesia. Urine is removed from the bladder by pressing on it with his hands.
It is forbidden to conduct such an examination in the following cases: acute form of cystitis, urethritis, as well as increased sensitivity to the contrast agents used in the procedure.
Radioisotope Examination
This research method is used to assess the functioning of the kidneys. Contraindication to the conduct may be the presence of acute diseases of the genitourinary system, intolerance to the components of the drugs that are used in the diagnosis. Before treatment, it is important to find out where the operations are performed with the expansion of the ureter best.
Therapy
The most common and effective way to treat ureteral enlargement is reimplantation. With this procedure, a new anastomosis is applied between the ureter and the bladder.
Operations can be minimally invasive and open. The first operation lasts for 125 minutes and requires hospitalization of the patient for up to a week. The second type is surgery, which lasts the same amount of time, but requires hospitalization from 14 to 16 days.
After the operation, the child may experience the following complications: acute pyelonephritis, colic in the kidneys, wound bleeding and stent migration in the lumen of the UMP.
Postoperative Recovery
Patient recovery lasts quite a while. Evaluation of the results of the operation will be remote. Doctors will judge the quality and effectiveness of the surgical intervention only a few years after the operation itself.
It is important to remember that there is nothing scary or dangerous in carrying out an operation. You should not be afraid and put it off for some time. According to statistics, success with surgical intervention is observed in 90% of patients. The faster the treatment of the disease is started, the higher the chance of getting a positive result.
Particular attention in the treatment of ureteral enlargement should be paid to its severity. The severity will be determined after obtaining the results of the clinical diagnosis and multivariate assessment of the doctor. In normal cases of ureteral dilation, the patient will recover after a few weeks after the operation. In more complex cases, the patient will need 10-15 weeks for rehabilitation.
To avoid the expansion of the ureter, it is important to monitor the condition of the body and treat the diseases of the genitourinary system in a timely manner. It is also important to stop taking a large amount of fluid if the urinary system does not have time to remove it from the body in time.