Renal prolapse, or nephroptosis, is quite common. Most often, the right kidney falls, and left-sided or bilateral pathology is a rare occurrence. In normal limits, vagus kidneys have a positive effect on urine outflow. But in the case when the displacement distance exceeds the norm, nephroptosis develops on the left (according to ICD-10, the disease code is N28.8). Below we will talk more about this disease, its causes, symptoms and treatment options.
What it is
Left-sided nephroptosis is considered pathological mobility of the left kidney. This disease is manifested by the release of an organ from its natural boundaries and a change in its area of location. The more complex the form of the pathology, the farther the kidney goes. It can sink to the small pelvis or move into the abdominal cavity.
Nephroptosis on the left of 1 degree does not create any discomfort. A person begins to feel a serious displacement only with the appearance of painful signs. The mobility of the kidney is especially felt when the patient walks or stands. Most often, female representatives suffer from bias. This is due to the physiological characteristics of the body. In women, the anatomical bed is not as deep as in men. In addition, it is wider. Also, women have somewhat weaker abdominal muscles, and the fat capsule is characterized by increased friability. As a rule, patients with nephroptosis on the left are hard to bear and give birth to a baby. In this case, the body experiences severe stress.
Causes
In a natural state, the right kidney is located slightly lower than the left. So nature has created the necessary bias of the ureters for a full outflow of urine. During breathing, as well as when changing the position of the body, both kidneys move from their bed up and down two centimeters. But with nephroptosis on the left, this distance increases to ten centimeters. In its natural place, the organ is retained by fascia, ligaments, intra-abdominal pressure and adipose tissue.
If this supporting mechanism is broken, a healthy kidney turns into a vagus. It is worth noting that the left organ is shifted much less frequently from its bed. This is due to the fact that its ligamentous apparatus is much stronger than that of the kidney on the right, which is also located somewhat lower.
Nephroptosis on the left and on the right occurs for the same reasons:
- A sharp decrease in weight, resulting in a decrease in the fat capsule of the kidney, which leads to the omission of the organ.
- Significant decrease in tone and muscle aging. For this reason, not only the kidneys are lowered, but also other organs of the abdominal region. Muscles can weaken due to many different factors. Most often, this is a prolonged birth, repeated pregnancies and a sharp loss of body weight.
- Infectious diseases.
- Lumbar injuries with damage to ligaments (sharp blow, strong concussion, etc.), swelling and hematoma of soft tissues can displace the kidney from its anatomical site.
- Congenital diseases of the bed and legs.
- Weight lifting.
- Severe abdominal muscle strain during pregnancy.
Renal prolapse often develops in people with an asthenic physique, underdeveloped body fat, and weak abdominal muscle tone.
The first signs of nephroptosis on the left
At first, the disease practically does not manifest itself. The patient can ignore his feelings, often mistakenly assuming that they are not associated with any disease. Experts recommend contacting a doctor immediately after the appearance of at least one of these signs. So, the first symptoms of nephroptosis on the left are:
- Dull pain in the lumbar region, which increases with any physical exertion.
- Painful sensations of an unstable nature in the abdomen.
- An admixture of blood and protein in the urine.
At this stage, the pathology is manifested by pain with severe coughing, physical stress, and the transfer of heavy objects. The pain can be pulling, stitching or aching. She disappears after a short rest. Periodically, the patient experiences seizures similar to renal colic, during which the patient may feel sick, sweat, turn pale, some develop vomiting and fever. Pain is often given to the groin or genitals. The duration of such an attack can be different.
Main symptoms
After a while, moderate nephroptosis develops on the left, and the symptoms become more pronounced. During this period, the patient has the following symptoms:
- Decreased appetite, disruption of the digestive tract.
- Constant pain in the abdomen, which interferes with normal life.
- The appearance of puffiness, pyelonephritis.
- Violation of blood pressure.
- Frequent dizziness.
- Violations of the nervous system.
- Hypertension
- Inflammation of the pelvis, the formation of stones. This is due to a violation of the blood supply to the diseased organ.
The last two signs appear in patients who consulted a doctor too late. During development, pathology is difficult to diagnose, and it is often confused with other diseases. At the second stage, nephroptosis may be mistaken for appendicitis. In addition, sometimes pathology is confused with cholecystitis or colitis.
Stages
At different periods, prolapse of the kidney may have a different degree of severity. Depending on this indicator, the disease is divided into three consecutive degrees.
- Nephroptosis on the left of the 1st degree is determined by palpation: in a standing position, the left kidney moves one vertebra into the lumbar region. When a person is in a prone position, the organ returns to its place, while there should not be any unpleasant sensations. Signs of the first stage are pulling pains on the left side and in the lower back, aggravated during exertion.
- Nephroptosis on the left of the 2nd degree is expressed by omission of the kidney into two vertebrae. The pains become much longer and more intense. Sometimes bouts of colic and nausea may occur. An indisposition appears, the skin turns pale. In connection with the violation of the outflow of urine, it stagnates, which leads to pyelonephritis, cystitis and other pathologies.
- The third stage of the disease has the most difficult course. During this period, inflammatory processes occur in the organs of the genitourinary system, hypertension and hydronephrosis develop. Often, treatment of renal nephroptosis on the left in the third stage requires hemodialysis therapy. In some cases, urgent transplantation becomes necessary.
Diagnostics
During diagnostic measures, the doctor interviews the patient, conducts an examination with palpation of the kidneys. If the doctor suspects nephroptosis, the patient is sent for examination. As a rule, this includes:
- analysis of urine and blood for residual creatinine, nitrogen and urea;
- Ultrasound of the kidneys;
- intravenous excretory urography;
- X-ray examination.
Drug treatment
Medicines for lowering the kidneys are used only in the form of complex therapy. As a rule, medications are prescribed to treat symptoms and to alleviate possible consequences. Most often, the patient is prescribed:
- antispasmodics to combat muscle spasms in the kidney;
- antibacterial agents to eliminate inflammation;
- antihypertensive drugs to normalize pressure in the kidneys;
- analgesics to eliminate the pain symptom.
Conservative treatment
The first degree of the disease allows you to abandon surgery. In this case, therapy is carried out as follows:
- Compression underwear. During treatment, it must be worn constantly and removed only in a prone position.
- Massage the abdomen.
- Physiotherapy exercises to strengthen muscles.
- In the event of a disease due to a sharp weight loss, enhanced nutrition is prescribed.
- Exclusion of serious loads.
- Sanatorium-resort therapy.
Surgery
The second and third stage of the disease is most often treated with surgery. This operation is called nephropexy and is performed under general anesthesia. Most often, access to the left kidney is provided using the laparotomy method or laparoscopy. An improperly located kidney is attached to soft or bone tissue. For this, a muscle flap is used. To prevent the recurrence of the disease, a fragment of the peritoneum is sutured to the capsule of the filtering organ.
In the event that surgery on the abdominal wall is contraindicated, access to the kidney is through small incisions in the lumbar region.
Rehabilitation period
After surgery, the patient is prescribed a bandage that must be worn for three months. During this period, you should eat properly and refrain from physical exertion. Three months later, a follow-up examination is conducted, at which doctors decide on the possibility of doing special gymnastics to restore the body. In the presence of inflammation, repeated blood and urine tests are prescribed, as well as an ultrasound scan. After that, specialists select a treatment course.
Forecast
With the timely detection of pathology, one can count on a favorable prognosis. Therapy helps the patient to get rid of the disturbing symptoms and return to the usual life rhythm. However, doctors do not recommend strong physical exertion and active labor after surgery, and patients who have standing work are advised to change their profession.
Possible complications
When the kidney goes down, a serious ureteral inflection can occur, as a result of which the outflow of urine is disturbed or vesicoureureral reflux is manifested. In this case, fluid from the bladder enters directly into the kidney.
If the urine stagnates, bacteria will begin to appear in it, which is fraught with the development of infections of the genitourinary system. In addition, the risk of kidney stones is increased. The most serious complication is hydronephrosis. This is a pathological expansion of the pelvis and calyx, in which tissues atrophy, and the organ itself ceases to function properly.
The kidneys cease to cleanse excess fluid and harmful substances from the blood well, which leads to kidney failure.
Prevention
Quality therapy can completely relieve the patient of kidney problems. But if time is lost, the pathology was not treated, and renal failure arose, then a person will depend on the hemodialysis procedure all his life.
That is why it is necessary to have an idea of what nephroptosis means on the left or on the right and how to treat it. Prevent the onset of the disease from childhood. This is especially true for people with congenital pathologies of the kidneys and with a hereditary predisposition. Prevention is as follows:
- physical exercise;
- regular medical examination;
- proper nutrition and prevention of excess weight.
Conclusion
Any disease is easier to prevent than to cure later. But if the first symptoms appear, do not waste time. You should immediately seek help from a therapist or nephrologist. For quality treatment, you need not only the qualifications of a doctor, but also the active participation of the patient himself.