Timely therapy for expanding the kidney cups not only helps to avoid complications, but also prevents the risk of surgery, because pathology can lead to the formation of stones, and, in addition, to kidney necrosis. The disease in question can proceed unnoticed to its last stage, therefore, in order to determine it, you need to know about the features of the functioning of the organ. The term "pyelocalicectasia" in medicine means a pathological expansion of the ureter, pelvis and calyx of the kidney, which is congenital or acquired in nature.
This condition can be one-sided, or it can be bilateral. In the first case, doctors interpret the diagnosis as pyelocalicectasia of the right or left kidney. And in the second case, the diagnosis is interpreted as bilateral pyelocalicectasia. It must be borne in mind that the expansion of the cups and pelvis of the kidneys causes the appearance of inflammatory processes, and over time this leads to extremely serious complications.
What is the norm of renal proportions?
The norm of the proportions of the kidney in an adult is one hundred and five millimeters in length and forty-five in width. When these parameters change, a person experiences problems with urine diversion. The presence of expansion of the calyxes of both kidneys (with bilateral pyelokalikoektazii), as a rule, affects the urinary system and the organs that are associated with it. The disease may be a consequence of prostate adenoma or may result from a tumor in the bladder. In some situations, cup expansion in adults is observed in the presence of cancer, injuries and swelling of the organ, against the background of renal infections, including during pregnancy.
Deformation of the renal pelvis is congenital, and a direct predisposition to it can be inherited. In the early stages, the pathology may not exhibit vivid symptoms. In the event that the violation is not diagnosed in time, then the chronic stage will come with a full bunch of complications. If the organ becomes too large, its size will be impossible to adjust, and you will have to remove the kidney.
In the norm, the expansion of the calyx of the kidney should not be.
Stages of this disease
An abnormally large kidney size is not always manifested by symptoms in the form of pain, itching, and pronounced discomfort in the affected area. This is often a silent disease, gradually aggravated and characterized by a smooth change of stages. Right-sided and left-sided expansion of the kidney cups are conditionally divided into several stages, which are characterized by a number of the following clinical differences:
- At the initial stage, the ailment does not differ in external manifestations, the violation is determined only by conducting ultrasound.
- At the middle stage, a moderate expansion of the calyx is observed. A person has difficulty urinating.
- At the chronic stage, the patient noticed a large swelling of the limbs along with a change in the color of urine. Going to the toilet “a little” becomes very painful and difficult. Periodically, pain may occur in the lumbar region.
In some situations, with progressive inflammatory processes, patients may experience a rise in body temperature, and in addition, aching pain occurs in the sacral region. Young children, as a rule, begin to be very capricious and very often ask for a toilet. Against the background of the presence of general swelling, patients observe a feeling of thirst along with increased consumption of water. It is imperative to pass urine tests and, if abnormalities are found, consult a doctor immediately.
The main reasons for the expansion
The appearance of lower back pain is one of the possible symptoms associated with the expansion of the kidney cups. The main factor affecting this process is a violation of the circulation of urine in them and the creation of an excessive load. Pyelocalicectasia of the right kidney is observed no less than the pathology of the paired organ on the left side, however, according to statistics, it is considered predominant, especially in people who are overweight, in addition to those who sleep on the right side, thereby creating additional pressure, due to which the renal cup is deformed. But the main reasons for the development of the expansion of the calyx of the left kidney, as well as the right, are two:
- The process of violation of the outflow of urine. The processes of increasing internal and external pressure in the urinary system lead to the fact that urine passes much more slowly and stagnates in parallel, and the volume of its accumulation directly increases greatly, which leads to an increase in organ size. This is often observed in pregnant women and men suffering from prostatic hyperplasia.
- Another reason for the expansion of the kidney cups is the reverse flow of urine. Pathology leads to an excess of urinary fluid in the sinus of the kidney, which increases the pressure on the walls of the pelvis. All this leads to internal stretching. This disease is usually congenital, proceeding against the background of ureteric reflux.
Symptoms of this disease
The expansion of the cups and pelvis of the kidneys to a certain point, as a rule, is almost not visible. This is the reason for the late treatment of patients for medical care. Further complications are possible on this basis. Open symptoms for this disease are not characteristic, however there are a number of signs by which the initial stage of development of the disease is determined. A characteristic feature of the disease are pulling pains in the lumbar region.
Difficulty with urination during the expansion of the kidney cups begins to be observed much later, and this serves as an additional reason to undergo a medical examination. The urinary pelvis, which has stagnated, is open to various infections, as a result of this, people often develop pyelonephritis, which is accompanied by acute pain along with a fever of up to thirty-nine degrees. Against the background of all this, there is a great danger of an abscess.
The development of this disease during pregnancy
At the first symptomatology of the expansion of the calyx of the left kidney or the right, it is necessary to consult a doctor. In most women, pyelokalikoectasia during pregnancy is detected during elective ultrasound examination. Of course, the discovery of this diagnosis is always a complete surprise, since at the initial stage the pain is completely absent, just like other pronounced symptoms.
Typically, the process of kidney deformation begins due to the fact that the uterus increases in size and puts pressure on the ureter. The process may be more pronounced on one side. Pyelokalikoectasia on the left or on the right is quite probable. The bilateral nature of the disease is very rare and depends largely on the characteristics of the body.
An additional factor that increases the risks of the disease is the change in the hormonal background due to pregnancy, along with the predominance of estrogens, which affect the contractility of the bladder. The risks of developing this pathology can be detected by analysis in case of exceeding the norm of protein, urea and sugar. The presence of an uncharacteristic increase in pressure should also make the patient alert and force to undergo an ultrasound examination.
As part of the prevention and adjustment of pyelocalicoectasis in the presence of pregnancy, it is necessary to monitor the outflow of urine, and, in addition, take measures to improve it. Daily fixation of the daily volume of urine will help to sound the alarm at an early stage of the manifestation of the disease. A special set of exercises is recommended that will help reduce the pressure of the uterus on the kidneys. To do this, it will be enough just a few times a day to stand on your elbows and knees for twenty minutes.
Kidney calyx enlargement
This disease in some cases acts as a congenital malformation and may appear as a result of intrauterine developmental disorders. Thus, the renal pelvis can sometimes be deformed in the newborn. Surgery in this case is an extremely risky event. It is worth noting that infants develop concomitant serious complications, mainly with urination.
This disease is diagnosed starting from the sixteenth to the twentieth week of pregnancy when the renal pelvis is already visible in the fetus. Boys are much more likely to experience similar congenital abnormalities compared to girls, so women in labor need to undergo ultrasound more often to determine the sex of the child early. Congenital expansion of the cup and pelvis system in a child after reaching one year of age can by itself pass through the gradual development of the urinary system, especially in cases where the child is born prematurely.
What can be the complications of this ailment?
Against the background of this disease, a person may experience extremely painful urination. The increased size of the kidneys, although it does not annoy with pain, can lead to complications that also require surgical intervention. The processes of dilatation of the right and left kidneys against the background of persistently high blood pressure entail stagnation of urine along with a change in its composition. With a further progression of complications, hydronephrosis may occur along with kidney failure. Among other things, there is a high probability of the appearance of stones due to changes in the chemical composition and urinary density. At the initial stage of development, bilateral pyelokalikoectasia leads to such complications:
- Urination can be difficult and very painful.
- There are increasing pain in the lumbar region.
- There is an increased risk of catching secondary infections.
- In the presence of a chronic stage, the patient may experience diffuse kidney damage.
Diagnosis of this pathology
An expansion of the kidney cups by ultrasound can be seen.
This disease is also detected by x-ray method. Modern research apparatuses can show not only the expansion of the cups, but also shed light on the factors of the appearance of the disease. The sooner a change in the kidneys is detected, the faster it can be cured, so you should not neglect a scheduled examination every six months. The examination result is better to be at hand, for this you should make copies of clinical documents. The fact is that in some cases, doctors need to see the dynamics of the course of the disease, and medical records may be lost or open in the wrong hospital where they consult.
How to treat the expansion of the cups of the kidneys: right, left or both at once?
Disease treatment
The treatment of such a pathology may be therapeutic or require a surgical technique to eliminate the problem in the form of nephrectomy. With non-surgical therapy, the patient is selected a complex of drugs that includes antispasmodic drugs along with antibiotics and local effects, which are aimed at improving microcirculation in the kidney tissue. Drugs for therapy are also used to prevent diseases in the future, with some difference in dosage and frequency of use. With kidney disease, there are a number of diets, and in addition, types of medicinal chloride and sodium mineral waters, which are taken as directed by a doctor. But those should not replace the intake of ordinary liquid during the day.
Surgical intervention is required when the kidneys can no longer perform their functions, die off or cause harmful changes in other organs. Depending on the degree of the disease and the diagnosis, the operation involves the absolute removal of the failed organ or its correction at an early stage through plastic surgery. Thus, the kidney is sutured, it is returned to its previous size and, if necessary, cleaned in addition from stones.
The operation, which is aimed at reducing the expansion of the kidney, mainly proceeds under general anesthesia. A cavity technique is possible, as well as manipulations using a laparoscopic device under local anesthesia. The choice of intervention may remain with the attending doctor, and also largely depends on the patient’s body and the presence of concomitant diseases. In the event of a successful outcome of the operation, the chance of recovery is very high. In the case of organ removal, the patient expects a period of very difficult and lengthy rehabilitation along with disability with stringent requirements for diet and drinking regimen.
Patient reviews about this pathology
Many patients write that the expansion of the renal calyxes was diagnosed late in them, so they could not avoid the operation, since drug treatment in the later stages is completely ineffective. Reportedly, some went through a kidney correction, while others had to go through an organ removal operation.
Patients say that for some patients they perform a cavity technique, and manipulations using laparoscopic technologies are used to treat others. But in that and in another case, the surgical intervention, according to the stories of patients, is tolerated quite difficult.
People write that, apart from the difficult period of rehabilitation, it is very difficult to tolerate the need for a strict and long diet. It is especially difficult for those patients who have had one kidney removed.